摘要
目的：探讨肾透明细胞癌、乳头状细胞癌MRI表现差异，提高诊断准确率。方法：回顾性分析2011年4月—2013年6月本院36例行MRI平扫与增强检查并经病理证实的肾细胞癌患者的MRI表现，结合其病理结果分析、总结不同亚型肾细胞癌的MRI表现特点。结果：36例肾细胞癌患者中，肾透明细胞癌31例（32灶），乳头状细胞癌5例（5灶）。肾透明细胞癌及肾乳头状细胞癌MRI平扫表现类似，大多数病灶信号不均： 肾透明细胞癌T1WI以等、低混杂信号为主；T2WI以等、高或等高低、高低混杂信号为主。肾乳头状细胞癌MRI平扫T1WI、T2WI均以混杂信号为主。增强检查，肾透明细胞癌于皮质期强化方式以中度-明显重度强化为主，实质期迅速下降，呈“快进快出”征象；肾乳头状细胞癌强化方式以持续性轻中度强化为主；两者多数为不均匀强化，考虑为肿瘤内发生出血、坏死及囊性变所致。结论：MRI对肾透明细胞癌及肾乳头状细胞癌的诊断及鉴别诊断有一定的价值，其中增强检查能更有效的对两者进行鉴别。
Abstract
Objective: To investigate the difference in imaging features of renal clear cell carcinoma and renal papillary carcinoma with MRI, and to improve the diagnostic accuracy. Methods: Thirty-six cases of renal cell cancer from April 2011 to June 2013 in our hospital were confirmed pathologically and all of them had routine and enhanced MRI. The imaging features of these 36 cases were analysed retrospectively, their characteristics and differences were summarized. Results: In 36 cases of renal cell carcinoma, 31 cases were of clear cell carcinoma(32 lesions), 5 cases were of renal papillary carcinoma(5 lesions). Renal clear carcinoma and renal papillary carcinoma had nearly similar imaging features on plain MRI scans, most lesions were inhomogeneous: most of the renal clear carcinoma showed moderate and low signal on T1WI and most of the cases showed mixed signal on T2WI, most of the renal papillary carcinoma showed mixed signal both on T1WI and T2WI. On enhanced MRI, renal clear carcinoma were mainly moderate obviously and significantly enhanced in the cortical phase, and rapidly decline thereafter; renal papillary carcinoma were mainly mildly to moderately enhanced. Both of them showed heterogeneous enhancement, due to bleeding, necrosis and cystic degeneration within the tumor. Conclusion: MRI has important value, especially enhanced MRI in the differential diagnosis between renal clear cell carcinoma and renal papillary carcinoma.
关键词
癌 /
肾细胞 /
磁共振成像
Key words
Carcinoma /
renal cell /
Magnetic resonance imaging
刘常青;邢 伟;孙 军;卢海涛.
MRI增强检查对肾透明细胞癌与乳头状细胞癌的鉴别诊断价值[J]. 中国临床医学影像杂志. 2014, 25(6): 426-428
LIU Chang-qing;XING Wei;SUN Jun;LU Hai-tao.
Diagnosis and differential diagnosis of renal clear cell carcinoma and renal papillary carcinoma with enhanced MRI[J]. Journal of China Clinic Medical Imaging. 2014, 25(6): 426-428
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