【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14³0 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22³9 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26⁴1 HU、28⁴6 HU,局部肾盏均受压、变形。MRI平扫均表现为T₁WI等低信号,T₂WI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。更多还原

【Abstract】 Objective To investigate the clinical characteristics and CT,MRI features of calyceal cavernous hemangioma. Methods 8 cases of calyceal cavernous hemangioma at our institution were collected. The clinical,CT and MRI data including plain CT and enhanced scanning,plain MRI scanning of 8 patients and 7 cases of enhanced MRI scanning were analyzed retrospectively. Results Of all 8 cases,the proportion of males and females was equal. The patients’ age range wasfrom 18 to 55 years and mean age of 42. 1 years. Calyceal cavernous hemangioma of these 8 patients had a history of 2to 9 years,a mean of about 5. 4 years. All patients have intermittent recurrent painless gross hematuria and unilateral ureteric spurting on cystoscopy. 4 cases have back pain and 4 cases have blood clot in urine. All patients have only one lesion,3 of them are in the left while the rest are in the right. Of all 8 lesions,3 are in the upper calyces,2 in the middle calyces while others are located in the lower calyces. Patients’ kidneys are of normal size,with no focal contours or renal protrusion.Lesions appeared as iso-to hypodense,lobulated arborized masses without calcification,whose CT value varied from 14 to 30 HU. On enhanced scanning,the masses had CT values which varied from 22 to 39 HU,all have clear margins,displaced of surrounding vessels which have no connection with masses at cortical stage. At medullary and excretory stage,masses still have mild uneven enhancement with CT values varying from 26 to 41 HU and 28 to 46 HU respectively. Additionally,on enhanced scanning,calyces around the mass were compressed and deformed. Finally,masses are had clear margins on MRI imaging,appeared to be of equal to low signal on T1 WI,mixed signal on T2 WI and have similar enhanced scanning appearance with CT. Conclusion Though calyceal cavernous hemangioma is rare,it still has some characteristics features. Calyceal cavernous hemangioma is often occurs in young and middle-aged patients with intermittent recurrent painless gross hematuria and no prolonged cachexia. Furthermore,the kidney is of normal size and has single lobulated,arborized masses of uneven intensity and signal on plain CT and MRI scan. The mass showed mild uneven progressive enhancement on enhanced scans. Vessels around were effaced and displaced,with no connection with the mass. Finally,calyces around the mass were compressed and deformed.更多还原