【摘要】 目的提高对肾脏黏液样小管状和梭形细胞癌的认识。方法回顾性分析5例(男3例、女2例,年龄23~61岁,平均49岁)经手术病理证实的肾脏黏液样小管状和梭形细胞癌的CT和MRI表现,观察肿瘤的部位、大小、形态、包膜、钙化、CT密度、MRI信号、增强扫描的强化方式与程度、肾周侵犯及远处转移等情况,并作文献复习。结果 5例术前均行CT平扫及增强检查,2例并行MRI平扫及增强检查。4例位于左肾,1例位于右肾;均呈类圆形,长径1.5~7.5 cm,与肾组织分界清,3例有假包膜。CT平扫1例呈稍高密度,1例呈稍低密度,3例呈等密度,其中2例有钙化,1例有囊变。2例行MRI检查者,T1WI上1例呈稍低信号为主伴有更低信号,1例基本呈等信号,T2WI上1例呈稍高-高信号,另1例呈稍高-高信号为主夹杂少许低信号。CT、MRI三期增强扫描肿瘤强化均明显低于肾皮质,3例皮髓期、实质期其内见点状或小片絮状轻度强化,2例皮髓期、实质期呈较均匀轻度强化,排泄期均呈持续性强化。5例均无肾周侵犯、淋巴结及远处转移。结论肾黏液样小管状和梭形细胞癌CT、MRI表现有一定的特征性,尤其皮髓期、实质期其内小点状及片絮状强化及排泄期持续性强化的强化方式可能对它的诊断有重要价值。更多还原

【Abstract】 Objective To improve the understandings about CT and MR appearances in Mucinous tubular and spindle cell carcinoma of the kidney. Methods The CT and MR features of Mucinous tubular and spindle cell carcinoma of the kidney in five patients( 3 male,2 females,Age 23- 61 years,mean 49 years) were retrospectively analyzed,which were confirmed by postoperative histopathology. The tumor features of position,size,appearance,capsules,calcication,density,intensity,degree and pattern of enhancement,perinephric extension and metastasis were observed,and the literature was reviewed. Results 5 cases underwent preoperative unenhanced and contrast-enhanced CT scans,2 cases also underwent unenhanced and enhanced MRI scans. 4 cases were located in the left kidney and 1 case in the right kidney; The shapes of tumor were all oval,maximum diameter of lesions ranged from 1. 5 cm to 7. 5 cm,the margins of tumors were distinct,the pseudocapsule could been seen in 3 cases. Unenhanced CT images showed slightly hyperdense in 1 case,slightly hypodense in 1 case and isodense in 3 case,2 cases showed with tumor calcification,1 case showed with cystic degeneration. 2 patients received MRI examination,signal intensities were basically iso-intensed in 1 case and another case was hypo-intensed intensities-based mixed,1 case was slightly hyper-to hyper-intensities on T2WI,another case was slightly hyper- to hyper-intensities-based mixed with a little hypo-intensities. The degree of enhancement of the tumors was apparently less than normal renal cortex on all enhanced phases of CT and MRI,3 cases showed mild patchy enhancement and 2 cases showed Mild homogeneous enhancement at cortico- medullary phase and nephrographic phase,the lesions enhanced continuously at the excretory phase. 5 cases hadn’t perinephric extension,lymph node and distant metastasis. Conclusion Mucinous tubular and spindle cell carcinoma of the kidney has certain characteristic CT and MRI findings,especially the pattern of enhancement may provide important infomation in the diagnosis.更多还原