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1、肾脏嗜酸细胞腺瘤的螺旋CT诊断与病理对照分析【摘要】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20.0〜87.0mm,平均53.5mmo1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
2、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。【关键词】肾嗜酸细胞腺瘤;诊断;螺旋CT;病理TheComprehensiveDiagnosisofRenalOncocytomabySpiralCTandPatho1ogy/ZHANGQing,LIJun~tang,ZHANGJin-feng,et
3、al.//MedicalInnovationofChina,2015,12(10):124-129[Abstract]Objective:ToanalyzetheproblemsindiagnosingrenaloncocytomabyspiralCTandpathology,inordertoimprovetheaccuracyofdiagnosis.Method:TheimagingfeaturesofCTof12lesionsconfirmedbypathologywereanalysedretrospectivelyandcorrelatedbypathologicdia
4、gnosis.ResuIt:11casesweresinglenodule,accompanyingwiththediameteroflesionwas20-87.0mm,average53.5mm.ONplainCTsean,1lesionshowedalittlehigherdensitythantherenalparenchyma*centralstellatescarshowedlowdensityshadow・Inthecorticalphase,5casesdisplayedinhomogeneousenhancement,and6casesdisplayedhomo
5、geneousenhancementinpart.Theenhanceddegreeofalllesionswerehigherthanthatofmedulla,andlowerthanthatofcortex.Inparenchymalphase,theenhanceddegreeofalllesionswerelowerthanthatofmedulla・Inexcretoryphase,thedensityofsolidpartoftumorwasequation,andbelowthatoftherenalparenchyma,whichwascorresponding
6、withthepathologicalfeature:thetumorwaslessofhemorrhage,necrosisandcysticdegeneration.Thecaseofbilateralmultiplerenallesionsalsofollowedthestrengtheningmethod.6casesshowedcentralslitshapedorstellateshapedscar,andallcasesshowednocalcification.Conclusion:Sincerenaloncocytomaisakindofbenignrenalt
7、umor,whichhassomeimagingfeaturesinenhancedspiralCTsean,takingrenalbiopsybeforeoperationorsurgeryfrozenbiopsywillbeusefultomaketherapyplanforthebenefitsofpatients.[Keywords]Renaloncocytoma;Diagnosis;SpiralCT;PathologyFirst-author?saddress:Qing