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目的 探讨肾血管平滑肌脂肪瘤 (错构瘤 )的诊断与治疗方法。方法 回顾分析 2 2例肾错构瘤的临床资料。结果 诊断符合率 B超为 5 4.5 % ,CT为 81.8% ,术前诊断错构瘤 18例 ,误诊为肾癌 4例 ,其中 3例术中冰冻切片示错构瘤。行肿瘤剜除 11例 ,肾部分切除 7例 ,肾切除 3例 ,肾根治性切除 1例。结论 CT是诊断错构瘤的首选检查手段 ,肿瘤体积小、脂肪含量少、瘤内出血是影像学改变不典型导致误诊的原因 ,仔细分析病史、影像学资料及术中冰冻切片可避免误诊 ,手术治疗应尽量采用保留肾脏的手术
Objective To investigate the diagnosis and treatment of renal angiomyolipoma (hamartoma). Methods The clinical data of 22 cases of renal hamartoma were retrospectively analyzed. Results The diagnostic accuracy rate was 54.5% for B ultrasound and 81.8% for CT. There were 18 cases of hamartoma preoperatively diagnosed and 4 cases misdiagnosed as renal cell carcinoma. Three cases of intraoperative frozen section showed hamartoma. Tumor removal in 11 cases, partial nephrectomy in 7 cases, 3 cases of nephrectomy, radical nephrectomy in 1 case. Conclusions CT is the first choice for the diagnosis of hamartoma. Small tumor size, low fat content and intratumoral hemorrhage are the causes of misdiagnosis caused by atypical radiological changes. Careful analysis of medical history, imaging data and intraoperative frozen sections can avoid misdiagnosis and surgery Treatment should be used to retain the kidney surgery