肾脏乏脂肪血管平滑肌脂肪瘤MRI诊断
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摘要
目的探讨肾脏乏脂肪血管平滑肌脂肪瘤(AML)(长径≤3 cm)MRI特征,提高对该病的诊断水平。方法回顾性分析2016年1月至2017年7月经手术病理证实的8例肾乏脂肪AML的资料,着重分析其MR T_2WI信号强度、均匀度、形态学特征、强化方式。结果 8例共8个病灶。T_2WI表现为均匀低信号者7例(7/8),1例(1/8)囊变者,其实质部分信号呈均匀低信号。上述特点在b值为0的扩散加权成像(DWI)表现得更明显。均匀强化者7例,1例囊实性病灶,实性部分均匀强化。8例病灶强化方式均为"快进快出"。结论 T_2WI均匀低信号是乏脂肪肾AML的MRI特征,b值=0的DWI表现得更明显,这些特征性表现有助于AML的诊断与鉴别诊断。
Objective To explore the MRI features of renal angiomyolipoma with minimal fat(diameter≤3 cm). Methods 3.0 MR images of 8 cases of surgical and pathologically proven angiomyolipoma were reviewed and analyzed.The MR features of the lesions were analyzed,with emphasis on the signal intensity and homogeneity on T_2WI,morphology and enhancement pattern. Results Seven lesions demonstrated hypointensity on T2 WI compared to the renal parenchyma,cystic degeneration or necrosis in 1 lesion.Homogeneous enhancement in 7 lesions,the solid part of the cystic-solid lesion also enhanced homogenously.The above characteristics in the DWI is more obvious when B value is 0.A phenomenon of quick staining and quick fainting was observed in 8 leisions. Conclusion The MRI features of renal angiomyolipoma with minimal fat were hypointensity on T_2WI,which is more obvious on DWI when B value is 0.These characteristic manifestations contribute to the diagnosis and differential diagnosis of AML.
Objective To explore the MRI features of renal angiomyolipoma with minimal fat(diameter≤3 cm). Methods 3.0 MR images of 8 cases of surgical and pathologically proven angiomyolipoma were reviewed and analyzed.The MR features of the lesions were analyzed,with emphasis on the signal intensity and homogeneity on T_2WI,morphology and enhancement pattern. Results Seven lesions demonstrated hypointensity on T2 WI compared to the renal parenchyma,cystic degeneration or necrosis in 1 lesion.Homogeneous enhancement in 7 lesions,the solid part of the cystic-solid lesion also enhanced homogenously.The above characteristics in the DWI is more obvious when B value is 0.A phenomenon of quick staining and quick fainting was observed in 8 leisions. Conclusion The MRI features of renal angiomyolipoma with minimal fat were hypointensity on T_2WI,which is more obvious on DWI when B value is 0.These characteristic manifestations contribute to the diagnosis and differential diagnosis of AML.
引文
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2 Kim KH,Yun BH,Jung SI,et al.Usefulness of the ice-cream cone pattern in computed tomography for prediction of angiomyolipoma in patients with a small renal mass[J].Korean Journal of Urology,2013,54:504-509.
3 Avila NA,Kelly JA,Chu SC,et al.Lymphangioleiomyomatosis:abdominopelvic CT and US findings[J].Radiology,2000,216:147-153.
4 Eble JN,Sauter G,Epstein JI,et al.World Health Organization classification of tumors:pathology and genetics(2004).Tumors of the urinary system and male genital organs[M].Lyon:IARC Press,2004.
5 Lane BR,Aydin H,Danforth TL,et al.Clinical Correlates of Renal Angiomyolipoma Subtypes in 209 Patients:Classic,Fat Poor,Tuberous Sclerosis Associated and Epithelioid[J].Journal of Urology,2008,180:836-843.
6 Hosokawa Y,Kinouchi T,Sawai Y,et al.Renal angiomyolipoma with minimal fat[J].International Journal of Clinical Oncology,2002,7:120-123.
7 Rosenkrantz AB,Hecht EM,Taneja SS,et al.Angiomyolipoma with epithelial cysts:mimic of renal cell carcinoma[J].Clinical Imaging,2010,34:65-68.
8 Obuz F,Karabay N,Se?il M,et al.Various radiological appearances of angiomyolipomas in the same kidney[J].European Radiology,2000,10:897-899.
9 Strotzer M,Lehner KB,Becker K.Detection of fat in a renal cell carcinoma mimicking angiomyolipoma[J].Radiology,1993,188:427-428.