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目的分析肾透明细胞癌(renal clear cell carcinoma,RCCC)的少见影像学表现,探讨其与病理的关系及临床意义,以提高诊断准确性。资料与方法搜集经手术病理证实的非典型RCCC19例患者资料。均行多层螺旋CT平扫、皮髓交界期和实质期增强扫描,3例行MRI平扫和增强扫描。复习影像及临床资料并与手术病理对照分析。结果 19例RCCC共20个肾脏病灶。19例中表现为少血供7例;囊性5例;多发性RCCC1例(2个病灶);合并外伤致肾周血肿1例;合并肾外病灶2例,其中1例为腹腔畸胎瘤,1例为肺癌;肾癌并显著侧支循环3例,其中1例合并动静脉瘘。结论 RCCC少见影像学表现包括:肿瘤为少血供,囊性,多发病灶,合并肾外肿瘤,肿瘤致侧支循环及动静脉瘘等。认识这些少见影像学表现有利于提高RCCC诊断的准确性,减少误诊。
Objective To analyze the rare imaging features of renal clear cell carcinoma (RCCC) and to explore its relationship with pathology and its clinical significance to improve the diagnostic accuracy. Materials and Methods The data of 19 patients with atypical RCCC confirmed by pathology were collected. All patients underwent multislice spiral CT scan, cutaneous junction and parenchymal enhancement scan. Three patients underwent MRI plain scan and enhanced scan. Review of imaging and clinical data and surgical pathology control analysis. Results 19 cases of RCCC a total of 20 renal lesions. Nineteen cases showed less blood supply in 7 cases, 5 cases of cystic disease, 1 case of multiple RCCC (2 lesions), 1 case of peritumoral hematoma caused by combined trauma and 2 cases of extrarenal neoplasia, of which 1 case had peritoneal teratoma , 1 case of lung cancer; renal cell carcinoma and significant collateral circulation in 3 cases, including 1 case of arteriovenous fistula. Conclusions The rare radiological findings of RCCC include: the tumor is a little blood supply, cystic, multiple lesions, combined with extrarenal tumors, tumor-induced collateral circulation and arteriovenous fistula. Recognition of these rare imaging findings can improve the accuracy of RCCC diagnosis and reduce misdiagnosis.