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目的探讨梯度回波化学位移成像在肾细胞癌(RCC)及肾血管平滑肌脂肪瘤(RAML)诊断中的价值。方法收集33例RCC和20例RAML,全部RCC病例和2例RAML经手术病理证实。所有病例均进行常规磁共振平扫及梯度回波化学位移成像。重点分析梯度回波化学位移成像序列中病变与肾实质、病变与肾周组织器官分界的成像特点。结果在反相位梯度回波序列中,RCC、乏脂肪的RAML病例与肾周脂肪、相邻组织器官的关系显示清楚;含有脂肪的RAML与肾实质分界显示清楚;5例RCC和18例RAML病例中的脂质成分均出现信号衰减。结论反相位梯度回波序列可以显示RCC与肾周组织器官的关系,对RCC的分期提供帮助;可以显示RAML内脂肪组织内部脂质的均匀程度。
Objective To investigate the value of gradient echo chemical shift imaging in the diagnosis of renal cell carcinoma (RCC) and renal angiomyolipoma (RAML). Methods 33 cases of RCC and 20 cases of RAML were collected. All cases of RCC and 2 cases of RAML were confirmed by operation and pathology. All patients underwent routine magnetic resonance imaging and gradient echo chemical shift imaging. Focusing on imaging features of lesions and renal parenchyma, lesions and perineural tissue boundaries in gradient echo chemical shift imaging sequences. Results In the antiphase gradient echo sequence, the relationship between RCC and fat-deficient RAML and the perinephric fat and adjacent tissues and organs was clear. The dividing line between RAML containing fat and renal parenchyma was clear. Five cases of RCC and 18 cases of RAML The lipid components in all cases showed signal decay. Conclusion The anti-phase gradient echo sequence can show the relationship between RCC and peri-renal tissues and organs, and help in the staging of RCC. It can also show the distribution of lipid in the adipose tissue within RAML.