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目的分析肾血管平滑肌脂肪瘤(RAML)的影像表现及其临床应用价值,提高对本病的认识。方法23例确诊的RAML,均行超声、螺旋CT检查,CT增强检查7例;8例行MRI检查。结果23例RAML超声检查呈高回声者11例,混合性回声者7例,等低回声者5例。术前诊断13例。CT平扫呈低密度者4例,等低混杂密度者14例,等高密度者5例。增强扫描呈均匀强化,并见延迟强化。脂肪性低密度是其特征性表现。术前诊断19例。MRI检查T1WI、T2WI呈中高信号3例,呈等低信号5例;8例T2WI脂肪抑制时均呈低信号或信号明显减低。术前诊断8例。结论CT及MRI检查、特别是CT薄层加多期增强扫描及MRI脂肪抑制技术是诊断RAML最有效的影像学方法,图像后处理技术对指导外科治疗具有一定的价值;而超声检查对无症状者病灶的检出及初诊非常重要;疑难病例需行穿刺活检确诊。
Objective To analyze the imaging manifestations of renal angiomyolipoma (RAML) and its clinical value and to raise awareness of the disease. Methods Twenty-three patients with confirmed RAML underwent ultrasound, spiral CT, CT enhancement in 7 cases and MRI in 8 cases. Results 23 cases of RAML ultrasonography showed high echo in 11 cases, mixed echo in 7 cases, such as hypoechoic in 5 cases. Preoperative diagnosis of 13 cases. CT scan showed low density in 4 cases, such as low-density mixed in 14 cases, such as high-density in 5 cases. Enhanced scan showed uniform enhancement, and see delayed enhancement. Fatty low density is its characteristic manifestation. Preoperative diagnosis of 19 cases. MRI examination T1WI, T2WI showed high signal in 3 cases, showed low signal in 5 cases; 8 cases of T2WI fat suppression were low signal or signal was significantly reduced. Preoperative diagnosis in 8 cases. Conclusion CT and MRI examination, especially CT thin layer plus multi-phase enhanced MRI and MRI fat suppression technology is the most effective imaging method for the diagnosis of RAML. Image post-processing technique has some value for guiding the surgical treatment; while ultrasound examination of asymptomatic The detection of lesions and initial diagnosis is very important; difficult cases need to puncture biopsy confirmed.