CAJ | 학술논문

目的探讨不典型肾血管平滑肌脂肪瘤的误诊原因,提高其诊治水平.方法回顾性分析20例不典型肾血管平滑肌脂肪瘤患者的临床资料.20例均行B超检查,17例行CT扫描,10例行MRI扫描,8例行IVU检查.5例接受保守治疗,15例接受手术治疗,其中3例行肿瘤剜除术,5例行肾部分切除术,7例行肾癌根治术.结果 B超诊断肾血管平滑肌脂肪瘤12例(12/20),CT诊断肾血管平滑肌脂肪瘤9例(9/17).5例保守治疗者获得随访,肿瘤大小无明显变化,无转移.15例手术治疗者术后病理检查均为肾血管平滑肌脂肪瘤,随访未见肿瘤转移或复发.结论大部分肾血管平滑肌脂肪瘤可通过B超、CT等影像学检查明确诊断;对于不典型肾血管平滑肌脂肪瘤,术前应仔细分析影像学检查,必要时应根据术中冰冻切片决定手术方案,减少不必要的肾切除.
목적 탐토불전형신혈관평활기지방류적오진원인,제고기진치수평.방법 회고성분석20례불전형신혈관평활기지방류환자적림상자료.20례균행B초검사,17례행CT소묘,10례행MRI소묘,8례행IVU검사.5례접수보수치료,15례접수수술치료,기중3례행종류완제술,5례행신부분절제술,7례행신암근치술.결과 B초진단신혈관평활기지방류12례(12/20),CT진단신혈관평활기지방류9례(9/17).5례보수치료자획득수방,종류대소무명현변화,무전이.15례수술치료자술후병리검사균위신혈관평활기지방류,수방미견종류전이혹복발.결론 대부분신혈관평활기지방류가통과B초、CT등영상학검사명학진단;대우불전형신혈관평활기지방류,술전응자세분석영상학검사,필요시응근거술중빙동절편결정수술방안,감소불필요적신절제.
Objective To investigate the misdiagnosis causes of atypical renal argiomyolipoma(RAML), and to improve its diagnosis and treatment. Methods We retrospectively analyzed the clinical datas of 20 patients with atypical RAML.Twenty cases made B-ultrasonography,17 cases made CT scan,10 cases made MRI scan,8 cases made IVU examination. of all patients, 5 cases were treated conservatively,15 cases underwent operations, 3 cases underwent tumor enucleation, 5 cases underwent partial nephrectomy, and 7 cases underwent radical nephrectomy. Results The positive diagnosis rate of ultrasonography and CT scan was 60%(12/20) and 53%(9/17). The 5 cases treated conservatively had no change by follow-up, no significant change in tumor size, without metastasis.Fifteen cases underwent operations were confirmed RAML after postoperative pathological examination, no tumor metastasis or recurrence in follow-up. Conclusions The majority of RAML can be diagnosed definitely by ultrasonography and CT scan. As to atypical RAML, we should carefully analyze image information before operation. Necessarily, we can decide operational plan according to frozen section, so as to avoid unnecessary nephrectomy.