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目的探讨肾脏癌肉瘤的影像表现。资料与方法回顾性分析经手术病理证实的10例癌肉瘤的影像表现。结果 MRI检查10例,肿瘤体积较大,信号明显不均匀,9例实性成分T1WI、T2WI均表现为等低混杂信号,1例T1WI呈略低、T2WI呈等信号;增强扫描9例表现为“花瓣”状强化,1例为轻度不均匀强化伴内部间隔轻度强化;扩散加权成像(DWI)显示实性部分呈明显高信号,坏死区呈略高信号。CT检查5例,均呈等及略低密度,1例肿瘤内部可见“点”状钙化。DSA检查1例,供血动脉增粗不明显,可见轻中度肿瘤边缘区“瘤染色”。结论肾癌肉瘤体积较大,瘤内多发坏死,实性成分T2WI呈等或略低信号,增强扫描强化程度低于正常肾实质并呈“花瓣”状及分隔强化,是其诊断要点;多种检查方法的联合应用有助于提高肾脏癌肉瘤的确诊率。
Objective To investigate the imaging manifestations of renal carcinosarcoma. Materials and Methods The imaging findings of 10 cases of carcinosarcoma confirmed by surgery and pathology were retrospectively analyzed. Results In 10 cases of MRI examination, the volume of tumor was larger and the signal was obviously non-uniform. Nine solid components of T1WI and T2WI showed low-level mixed signals. One case had slightly lower T1WI and equal signal on T2WI. Nine cases showed enhanced scanning “Petal ” shape enhanced, 1 case of mild heterogeneous enhancement with slight increase of internal interval; DWI showed that the solid part was significantly higher signal, the necrosis area was slightly higher signal. CT examination in 5 cases, were slightly lower density and so on, one case of internal tumor visible “dot ” like calcification. DSA examination in 1 case, blood supply artery thickening is not obvious, we can see the marginal zone of mild to moderate “tumor staining ”. CONCLUSIONS: The size of renal carcinoma is large and the tumor is multi-necrotic. The T2WI of solid component shows the signal of equal or slightly lower intensity, and the intensity of enhanced scanning is lower than that of normal renal parenchyma. The “petal” shape and separation enhancement are the main points of diagnosis. The combined application of multiple examination methods can help improve the diagnosis rate of renal carcinosarcoma.