中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
10期
124-128,129
,共6页
张庆%李军堂%张进凤%崔琳
張慶%李軍堂%張進鳳%崔琳
장경%리군당%장진봉%최림
肾嗜酸细胞腺瘤%诊断%螺旋CT%病理
腎嗜痠細胞腺瘤%診斷%螺鏇CT%病理
신기산세포선류%진단%라선CT%병리
Renal oncocytoma%Diagnosis%Spiral CT%Pathology
目的：分析肾嗜酸细胞瘤的多排螺旋CT增强扫描特征及病理表现，以提高诊断准确性。方法：对12例经手术后病理证实的肾嗜酸细胞腺瘤患者的多期增强CT影像学特点及病理结果进行回顾性分析。结果：11例为单发病灶，1例为多发病灶。病灶最大径20.0~87.0 mm，平均53.5 mm。1例行CT平扫显示肿瘤实质呈略高密度影，中心瘢痕呈低密度影。皮质期5例不均匀强化，6例肿瘤实性部分较均匀强化，所有病灶强化程度均高于髓质，低于皮质；实质期病灶强化程度均低于髓质，2例欠均匀强化，10例病灶密度趋向均匀强化；延迟期肿瘤实性部分整体密度较均匀强化并低于肾实质，与病理上该肿瘤较少发生出血、坏死、囊变相对应。其中1例双肾多灶病变亦遵循上述强化方式。6例见中央裂隙状或星芒状瘢痕，所有病例均未见钙化。结论：肾嗜酸细胞瘤是一种少见的肾脏良性肿瘤，多期螺旋CT增强扫描有一定影像学特点，如果能在术前提示到本病的可能性，可采取肾穿刺活检或手术中冰冻病理活检，对临床手术治疗方案的制定有重要参考意义。
目的：分析腎嗜痠細胞瘤的多排螺鏇CT增彊掃描特徵及病理錶現，以提高診斷準確性。方法：對12例經手術後病理證實的腎嗜痠細胞腺瘤患者的多期增彊CT影像學特點及病理結果進行迴顧性分析。結果：11例為單髮病竈，1例為多髮病竈。病竈最大徑20.0~87.0 mm，平均53.5 mm。1例行CT平掃顯示腫瘤實質呈略高密度影，中心瘢痕呈低密度影。皮質期5例不均勻彊化，6例腫瘤實性部分較均勻彊化，所有病竈彊化程度均高于髓質，低于皮質；實質期病竈彊化程度均低于髓質，2例欠均勻彊化，10例病竈密度趨嚮均勻彊化；延遲期腫瘤實性部分整體密度較均勻彊化併低于腎實質，與病理上該腫瘤較少髮生齣血、壞死、囊變相對應。其中1例雙腎多竈病變亦遵循上述彊化方式。6例見中央裂隙狀或星芒狀瘢痕，所有病例均未見鈣化。結論：腎嗜痠細胞瘤是一種少見的腎髒良性腫瘤，多期螺鏇CT增彊掃描有一定影像學特點，如果能在術前提示到本病的可能性，可採取腎穿刺活檢或手術中冰凍病理活檢，對臨床手術治療方案的製定有重要參攷意義。
목적：분석신기산세포류적다배라선CT증강소묘특정급병리표현，이제고진단준학성。방법：대12례경수술후병리증실적신기산세포선류환자적다기증강CT영상학특점급병리결과진행회고성분석。결과：11례위단발병조，1례위다발병조。병조최대경20.0~87.0 mm，평균53.5 mm。1례행CT평소현시종류실질정략고밀도영，중심반흔정저밀도영。피질기5례불균균강화，6례종류실성부분교균균강화，소유병조강화정도균고우수질，저우피질；실질기병조강화정도균저우수질，2례흠균균강화，10례병조밀도추향균균강화；연지기종류실성부분정체밀도교균균강화병저우신실질，여병리상해종류교소발생출혈、배사、낭변상대응。기중1례쌍신다조병변역준순상술강화방식。6례견중앙렬극상혹성망상반흔，소유병례균미견개화。결론：신기산세포류시일충소견적신장량성종류，다기라선CT증강소묘유일정영상학특점，여과능재술전제시도본병적가능성，가채취신천자활검혹수술중빙동병리활검，대림상수술치료방안적제정유중요삼고의의。
Objective:To analyze the problems in diagnosing renal oncocytoma by spiral CT and pathology, in order to improve the accuracy of diagnosis.Method:The imaging features of CT of 12 lesions confirmed by pathology were analysed retrospectively and correlated by pathologic diagnosis.Result:11 cases were single nodule, accompanying with the diameter of lesion was 20-87.0 mm, average 53.5 mm.ON plain CT scan,1 lesion showed a little higher density than the renal parenchyma,central stellate scar showed low density shadow.In the cortical phase, 5 cases displayed inhomogeneous enhancement,and 6 cases displayed homogeneous enhancement in part.The enhanced degree of all lesions were higher than that of medulla, and lower than that of cortex.In parenchymal phase, the enhanced degree of all lesions were lower than that of medulla.In excretory phase, the density of solid part of tumor was equation, and below that of the renal parenchyma, which was corresponding with the pathological feature:the tumor was less of hemorrhage,necrosis and cystic degeneration.The case of bilateral multiple renal lesions also followed the strengthening method.6 cases showed central slit shaped or stellate shaped scar,and all cases showed no calcification.Conclusion:Since renal oncocytoma is a kind of benign renal tumor, which has some imaging features in enhanced spiral CT scan, taking renal biopsy before operation or surgery frozen biopsy will be useful to make therapy plan for the benefits of patients.
