肾盏海绵状血管瘤的临床特征及CT、MRI影像表现

发布时间：2018-08-18 12:30

【摘要】：目的探讨肾盏海绵状血管瘤的临床特征及CT、MRI影像特点。方法搜集经手术病理证实的肾盏海绵状血管瘤共8例,回顾性分析其临床及CT、MRI影像资料,CT平扫8例,增强8例;MRI平扫8例,增强7例。结果患者均表现为无痛性全程肉眼血尿,间歇反复发作,其中伴腰痛4例,尿中伴血凝块4例,膀胱镜检查均发现单侧输尿管开口喷血。8例均单发,共8个病灶,左肾3例,右肾5例,其中上组肾盏3例,中组肾盏2例,下组肾盏3例。肾脏大小均正常,局部肾轮廓均无外突,CT平扫均表现为等低密度、分叶分枝状肿块,境界不清,CT值14~30 HU,均无钙化,增强境界均清楚,皮质期均呈轻度不均匀强化,CT值22~39 HU,边缘均示受压、移位的血管,不与肿块相通,髓质期及排泄期仍呈轻度不均匀强化,CT值分别为26~41 HU、28~46 HU,局部肾盏均受压、变形。MRI平扫均表现为T_1WI等低信号,T_2WI高低混杂信号,境界清楚,增强表现同CT。结论肾盏海绵状血管瘤虽少见,但仍具有一定特点,中青年患者,无痛性全程肉眼血尿,间歇反复发作,病程较长,无恶病质表现,CT、MRI表现为肾脏不大,肾盏内单发分叶、分支状肿块,密度、信号不均,增强扫描呈轻度不均匀性渐进性强化,周围血管受压、移位,不与肿块相通,肾盏受压、变形。
[Abstract]:Objective to investigate the clinical features and MRI features of calyceal cavernous hemangioma. Methods eight cases of renal calyceal cavernous hemangioma proved by operation and pathology were collected. The clinical and CT MRI findings were retrospectively analyzed in 8 cases, enhanced MRI in 8 cases and enhanced MRI in 7 cases. Results all the patients showed painless hematuria in the whole course, intermittent repeated attacks, including 4 cases of low back pain, 4 cases of urine with blood clot, and 8 cases of unilateral ureteral orifice spurting blood by cystoscopy, including 3 cases of left kidney, 3 cases of left kidney, 8 cases of unilateral ureteral orifice, and 3 cases of left kidney. There were 5 cases of right kidney, 3 cases of upper group, 2 cases of middle group and 3 cases of lower group. The size of the kidney was normal, and the CT plain scan of the local renal contours without exophthalmos showed the same low density, lobular branched mass, unclear boundary and CT value of 1430 HU.There was no calcification, and the enhancement level was clear. In the cortical phase, the CT value of 22 ~ 39 HUU was slightly inhomogeneous enhanced. The margin showed compression, the displaced vessels did not communicate with the mass, the CT values of the medullary phase and the excretory phase were 2641 HUA 2846 HUU, respectively, and the local renal calyces were all compressed. The deformation.MRI plain scan showed low signal intensity such as T_1WI and high and low mixed signal on T _ 2WI. The boundary was clear and the enhancement was the same as that of CTT. Conclusion the calyceal cavernous hemangioma is rare, but it still has some characteristics. In young and middle-aged patients, painless hematuria, intermittent repeated attacks, long course of disease, no cachexia, small kidney and single lobular calyx can be found on MRI. Branched mass, density, uneven signal intensity, enhanced scan showed slight uneven progressive enhancement, peripheral blood vessels were compressed, shifted, not connected with the mass, the renal calyces were compressed and deformed.
【作者单位】：湖北省十堰市太和医院(湖北医药学院附属医院)医学影像中心;
【分类号】：R445.2;R730.44;R737.11

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