摘要
目的：分析肾盂癌的MRI表现，评价MRI的诊断价值并比较各序列的诊断意义。方法: 搜集资料完整并经病理证实的肾盂癌13例，行T1WI、T2WI、STIR、FIESTA轴位和/或冠状位扫描，其中6例行MRI增强扫描，2例行磁共振尿路水成像（MRU）。结果: MRI扫描示病灶大小为0.6cm×0.8cm～3.5cm×4.0cm。9例为局限型，表现为腔内肿块影，边界较清晰，肾窦脂肪受压向四周呈不同程度的移位。浸润型4例，肿瘤向肾实质内呈偏心性侵犯，肾轮廓轻到中度变形。合并肾积水3例，肾囊肿4例。MRI分期：Ⅰ~Ⅱ期7例，Ⅲ期3例，Ⅳ期3例。T1WI为均匀低信号7例，混杂信号2例，均匀等信号4例；T2WI为均匀略高信号6例，混杂高信号2例，等信号5例。6例增强扫描者，均匀强化4例，不均匀强化2例，5例病灶强化相对肾实质肿瘤呈低信号，1例增强后信号高于周围肾实质。2例MRU均未见明显异常。病理检查均为尿路移行上皮癌，病理分期：Ⅰ期0例，Ⅱ期6例，Ⅲ期4例，Ⅳ期3例。结论：MRI能较准确检出肾盂癌，冠状位扫描有利于发现和观察病灶，应作为常规序列。增强扫描有助于明确诊断。MRU并非必需扫描序列。MRI多种序列的结合分析有利于肾盂癌的定位及分期。
Abstract
Objective: To study the MRI manifestations of renopelvic carcinoma and to evaluate the diagnostic value of MRI. Methods: Thirteen surgically and pathologically proved cases of renopelvic carcinoma were examined with MRI pre-operatiｏｎ. All the cases were scanned with T1WI, T2WI, STIR and FIESTA sequences on axial and/or coronal position. Enhancing scans were performed in 6 cases. Two patients received MRU scan. Results: In these 13 cases, the size of lesions were between 0.6cm×0.8cm to 3.5cm×4.0cm on MRI. The lesions were limited mass in renal pelvis with clear borderline in 9 cases. In the other 4 cases, the lesions showed invasive growth and adjacent renal parenchyma was involved. Hydronephrosis and renal cysts were showed in 3 cases and 4 cases respectively. The lesions belonged to Ⅰ~Ⅱ stage(n=7), Ⅲ stage(n=3) and Ⅳ stage(n=3) by MRI staging. On T1WI, the lesions presented as homogeneous hypointense signal masses in 7 cases, heterogeneous signal intensity in 2 cases, isointense signal intensity in 4 cases. On T2WI, the lesions presented as homogeneous hyperintense signal in 6 cases, inhomogeneous hyperintense signal in 2 cases and isointense signal intensity in 5 cases. Homogeneous eｎhancement was presented in 4 cases, while inhomogeneous enhancement in 2 cases in cortical phase. Intensity of enhancement was mildly raised in 5 cases in parenchymal and pyelographic phases. There were no abnormal manifestations on MRU. The cases belonged to Ⅰ stage(n=0), Ⅱ stage(n=6), Ⅲ stage(n=4) and Ⅳ stage(n=3) by histopathology staging. All the cases were transitional cell carcinoma. Conclusion: Renopelvic carcinoma can be detected accurately by MRI. Coronal MRI is helpful for diagnosis. MRU is an alternative method and not essential in fact.
关键词
肾肿瘤 /
肾盂 /
磁共振成像
Key words
Kidney neoplasms /
Kidney pelvis /
Magnetic resonance imaging
关 键;胡道予;夏黎明;张 伶;方 磊.
肾盂癌的MRI诊断及评价[J]. 中国临床医学影像杂志. 2008, 19(7): 478-480
GUAN Jian;HU Dao-yu;XIA Li-ming;ZHANG Ling;FANG Lei.
Diagnostic value of MR imaging in renopelvic carcinoma[J]. Journal of China Clinic Medical Imaging. 2008, 19(7): 478-480
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