乏脂肪肾脏血管平滑肌脂肪瘤CT、MRI表现与病理对比研究

发布时间：2018-01-12 16:38

本文关键词：乏脂肪肾脏血管平滑肌脂肪瘤CT、MRI表现与病理对比研究　出处：《临床放射学杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨乏脂肪血管平滑肌脂肪瘤(LPRAML)CT、MRI和病理征象。方法搜集经手术病理证实的28例LPRAML患者的CT和MRI资料,观察分析肿瘤的成分(脂肪、出血、坏死、钙化)、肿瘤与周围正常组织的关系(包膜、角度)及肿瘤的强化方式,计算CT和MRI对该病各种征象的检出准确性。结果 28例中有23例(82.1%)在病理检查中检出含有脂肪成分,钙化、出血、坏死及假包膜均少见;18例(78.3%)HMB45呈阳性,16例(69.6%)Melan-A呈阳性。CT对脂肪成分的检出准确性低于MRI,且差异具有统计学意义(P0.05);对钙化成分的检出率高于MRI,且差异具有统计学意义(P0.05);CT和MRI对肿瘤假包膜、出血、坏死征象的检出率差异不明显(P均0.05)。CT对"劈裂征"或"杯口征"征象的检出情况优于MRI,且差异具有统计学意义(P0.05);CT和MRI增强扫描后呈均匀持续强化的病变分别占89.3%和82.1%,具有一定的一致性(Kappa=0.711)。结论脂肪成分、"劈裂征"或"杯口征"和均匀持续的强化特点均是CT和MRI对该病诊断的特殊征象,该病的确诊需要依靠病理和相关免疫组织化学检查。
[Abstract]:Objective to investigate the MRI and pathological features of LPRA MLCT in adipose adipose angiomyolipoma. Methods CT and MRI findings of 28 patients with LPRAML proved by operation and pathology were collected. The components of the tumor (fat, hemorrhage, necrosis, calcification), the relationship between the tumor and the surrounding normal tissue (capsule, angle) and the enhancement mode of the tumor were observed and analyzed. The accuracy of CT and MRI in detecting various signs of the disease was calculated. Results 23 out of 28 cases (82.1%) were found to contain fat, calcification and hemorrhage in pathological examination. Necrosis and pseudocapsule were rare. 18 cases were positive for HMB45 and 69.6A were positive for Melan-A. The accuracy of CT in detecting fat components was lower than that in MRI. The difference was statistically significant (P 0.05). The positive rate of calcification was higher than that of MRI, and the difference was statistically significant (P 0.05). There was no significant difference between CT and MRI in detecting false capsule, hemorrhage and necrosis. Ct was superior to MRI in detecting "split sign" or "cup mouth sign". The difference was statistically significant (P 0.05). The proportion of lesions with homogeneous and continuous enhancement after CT and MRI enhanced scan was 89.3% and 82.1, respectively. "split sign" or "cup mouth sign" and uniform and continuous enhancement are the special signs of CT and MRI in the diagnosis of the disease. The diagnosis of the disease depends on pathology and related immunohistochemical examination.
【作者单位】：苏州大学附属常熟医院放射科;第二军医大学长海医院放射科;
【基金】：第二军医大学长海医院“1255”计划基金项目(编号:CH12550900)
【分类号】：R737.11;R730.44;R445.2
【正文快照】： 肾血管平滑肌脂肪瘤是一种间叶源性错构瘤,肘静脉按2 ml/s的流率注入钆喷酸葡胺注射液(广主要由平滑肌细胞、血管及脂肪3种成分组成[1],影州康臣药业有限公司)15~20 ml行动态增强扫描像学上将不含脂肪成分或脂肪成分25%时称为乏(dynamic contrase enhanced,DCE),采用T1高分辨

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