肾血管平滑肌脂肪瘤的CT诊断及鉴别诊断(1)
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【摘要】 目的:探讨肾血管平滑肌脂肪瘤(RAML)的CT表现及其与肾癌和肾脂肪瘤的鉴别诊断。方法:回顾性分析15例经手术病理证实的RAML的CT表现。结果:15例RAML患者中经CT扫描共发现瘤灶21个,其中双肾发病2例,单肾发病12例,单肾多发瘤灶1例。瘤体长径为0.9~6.7 cm。术前正确诊断RAML 12例,准确率为80.0%,2例误诊为肾癌,1例误诊为脂肪瘤。结论:CT对含脂肪组织、影像表现典型的RAML诊断不难,但表现不典型的RAML易误诊。
【关键词】 肾血管平滑肌脂肪瘤; 肾癌; 体层摄影术; X线
The CT Diagnosis and Differential Diagnosisof Renal Angiomyolipoma/XIAO Kuan-xiang.//Medical Innovation of China,2012,9(33):091-092
【Abstract】 Objective:To investigate the renal angiomyolipoma ( RAML) and CT features of renal cell carcinoma and renal lipoma in the differential diagnosis.Method:A retrospective analysis of 15 cases proved by operation and pathology were RAML CT.Result:15 patients with RAML were detected by CT scan tumor 21,wherein the pair of kidney disease in 2 cases,single renal morbidity in 12 cases,single multiple renal tumor report of 1 cases.The tumor diameter is 0.9-6.7 cm.Correct preoperative diagnosis of RAML in 12 cases,the accuracy rate was 80%,2 cases were misdiagnosed as renal cell carcinoma,1 cases were misdiagnosed as lipoma.Conclusion:CT fatty tissue,image shows a typical RAML diagnosis is not difficult,but easy to misdiagnosis of atypical RAML.
【Key words】 Renal angiomyolipoma; Renal carcinoma; Tomography; X ray
First-author’s address:Laibin People’s Hospital,Laibin 546100,China
doi:10.3969/j.issn.1674-4985.2012.33.057
肾血管平滑肌脂肪瘤(renal angiomyolipoma,RAML)是起源于血管周上皮样细胞的间质性肿瘤,由不同比例的血管、平滑肌及脂肪组织构成,易出血,可恶变,影像表现相当复杂,有时不易与肾癌、肾脂肪瘤等鉴别。由于本病缺乏特异性临床表现,故术前诊断及治疗方案的选择有赖于准确的影像学诊断。笔者搜集15例经手术病理证实并有完整影像学资料的AML病例,回顾性分析其CT影像表现,旨在加强对该肿瘤的认识,提高术前诊断准确性。
1 资料与方法
1.1 一般资料 搜集笔者所在医院2007年1月-2011年6月收治的15例经手术病理证实为RAML患者的临床资料,其中男6例,女9例,年龄25~64岁,平均年龄(41.2±3.8)岁。临床表现有腰腹部胀痛、包块及血尿,部分患者无症状,体检发现。
1.2 方法 采用飞利浦6排螺旋CT扫描仪(Philips Blilliance 6),患者禁食约10 h左右,检查前30 min内口服3%Angiografin约500~800 ml充盈消化道。行常规双肾CT扫描,层厚约
3~8 mm。采用高压注射器经肘前静脉团注100 ml碘海醇或碘佛醇,流率为3 ......
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