【摘要】 目的 分析并评价浸润性肾盂癌的MRI影像学特征，以提高对其诊断与鉴别诊断的能力。方法 回顾性分析病理证实为浸润性肾盂癌的21例患者资料，所有患者均接受MRI平扫及DWI检查，其中3例进行PWI检查。结果 21例浸润性肾盂癌中心均位于肾脏集合系统，肾脏轮廓大多无明显变化。病灶在MRI平扫上大多呈稍长T₁稍短T₂信号，5例病灶呈混杂T₁混杂T₂信号，病灶在DWI均呈高信号。3例行PWI扫描呈轻-中度强化。3例行肾AMRA检查显示肾动脉受包绕推挤，4例伴有静脉癌栓形成，11例伴有腹膜后淋巴结转移，3例伴有肾上腺转移。1例伴有输尿管尿路上皮癌，2例伴有膀胱癌。结论 MRI具有多参数成像能力及较高的软组织分辨率，可清晰显示病灶部位及周围关系，对浸润性肾盂癌诊断及鉴别诊断具有较高的价值。更多还原

【Abstract】 Objective MRI manifestations of infiltrative renal pelvis carcinoma were analyzed and evaluated,to improve its diagnostic accuracy.Methods MRI features of 21 cases of infiltrative renal pelvis carcinoma confirmed pathologically were analyzed retrospectively.All patients underwent plain MRI scan and DWI examination,3 cases underwent PWI examination.Results The center of lesions for all cases were located in the renal collection system,with no change of the renal contour.Most lesions were presented as low signal intensity on T₁WI and slightly low signal intensity on T₂ WI,and heterogeneous signal intensity were showed on T₁WI and T₂ WI in 5 cases.All lesions were presented as high signal intensity on DWI.After contrast enhancement,mild and moderate enhanced lesions were demonstrated in 3 cases.Renal arteries were wrapped by renal pelvis carcinoma on renal AMRA in 3 cases.4 patients were accompanied with venous tumor thrombus and 11 patients with retroperitoneal lymph node metastasis.Adrenal gland metastases were showed in 3 cases.1 case was accompanied with ureter urothelial carcinoma,and 2 cases with bladder carcinomas.Conclusion MRI has a multi-parameter imaging capability and high resolution of soft tissue,and can clearly show the boundary of lesions and surroundings.MRI plays an important role in the diagnosis and differential diagnosis of infiltrative renal pelvis carcinoma.更多还原