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目的:探讨后肾始基腺瘤的CT特征及病理特点。方法:回顾性分析经手术病理证实的18例后肾始基腺瘤患者的临床资料,其中男10例,女8例,年龄33~75岁(平均50岁),均为单侧发病,左肾8例,右肾10例。患者均行CT平扫及增强扫描。分析18例患者CT和病理特点以及两者之间的关系。结果:18例患者CT平扫肿物呈等密度或稍低密度软组织肿块,最大径1.5~7.0cm,平均3.6cm;呈类圆形12例,不规则形6例;边界清晰6例,欠清晰7例,边界不清晰5例;密度均匀及不均匀各4例,密度欠均匀10例;CT值27~45HU,平均39HU。CT增强扫描示肿物未强化2例,轻到中度强化16例,呈软组织密度肿物影,低于肾实质强化水平,CT值50~77HU,平均63HU。11例延迟期扫描示肾盂肾盏有造影剂充盈并显示受压移位。患者术后病理学均证实为后肾始基腺瘤,光镜下肿瘤细胞体积较小,均匀分布,紧密排列,大小一致,形成长管样结构,部分可见乳头状或肾小球样结构。结论:后肾腺瘤的CT检查特征与病理特点有一定的相关性;正确认识其CT及病理学特点,有助于指导手术方案的制定,避免不必要的全肾切除术。
Objective: To investigate the CT features and pathological features of adrenal adenoma. Methods: The clinical data of 18 patients with posterior radical adeno-associated adenoma confirmed by surgery and pathology were retrospectively analyzed. There were 10 males and 8 females, aged 33-75 years old (average 50 years old) 8 cases of kidney, 10 cases of right kidney. Patients underwent CT scan and enhanced scan. 18 cases of patients with CT and pathological features and the relationship between the two. Results: The masses of CT scan in 18 cases showed equal density or slightly lower density soft tissue mass with the largest diameter of 1.5-7.0 cm (average 3.6 cm), 12 cases were round and 6 cases were irregular, the border was clear in 6 cases Clear in 7 cases, unclear boundary in 5 cases; uniform density and non-uniform in 4 cases, density less uniform in 10 cases; CT value of 27 ~ 45HU, an average of 39HU. CT enhanced scan showed 2 cases of non-enhancement of the tumor, mild to moderate enhancement in 16 cases, showed soft tissue density of the tumor, lower than the level of renal parenchymal enhancement, CT value of 50 ~ 77HU, an average of 63HU. Eleven patients with a delayed scan showed that the pelvis had a contrast agent filling and showed a shift in pressure. The pathology of the patients was proved to be adenosine adenoma of the posterior kidney. The tumor cells were smaller, evenly distributed, closely arranged and of the same size under the light microscope, forming a long tube-like structure and partially showing the papillary or glomerular-like structure. Conclusion: The features of CT examination of posterior renal adenoma have some correlation with pathological features. Correct understanding of the CT and pathological features can help guide the development of surgical plans and avoid unnecessary nephrectomy.