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目的分析乳头状肾细胞癌的MRI表现,探讨其与病理的关系。资料与方法回顾性分析经手术病理证实的9例乳头状肾细胞癌患者的影像学资料,其中7例行MRI检查,3例行螺旋CT检查。结果9例中,右侧6例,左侧3例;圆形或椭圆形7例,不规则2例。肿瘤直径2.7～7.3 cm,平均4.6 cm;肿瘤边缘光整7例,边缘结节状突起2例。T1WI呈低信号5例,等信号4例;T2WI呈低信号6例,等信号2例,高信号1例;T2WI显示假包膜6例。MR信号不均匀7例,均匀2例。9例动态增强扫描肿瘤实质成分为进行性延迟强化,皮髓交界期、实质期轻度强化8例,中度强化1例;肾盂期强化与实质期相仿。组织病理分型Ⅰ型7例,Ⅱ型2例。结论乳头状肾细胞癌具有一定的MR表现特征,动态增强可提供更多诊断信息。
Objective To analyze the MRI findings of papillary renal cell carcinoma and to explore its relationship with pathology. Materials and Methods Retrospective analysis of 9 cases of papillary renal cell carcinoma confirmed by surgery and pathology, including 7 cases of MRI and 3 cases of spiral CT. Results Among the 9 cases, 6 were on the right and 3 were on the left, 7 were round or oval, and 2 were irregular. Tumor diameter 2.7 ~ 7.3 cm, an average of 4.6 cm; tumor margin finishing 7 cases, 2 cases of edge nodular processes. T1WI showed low signal in 5 cases and equal signal in 4 cases. T2WI showed low signal in 6 cases, equal signal in 2 cases and high signal in 1 case. T2WI showed pseudocapsule in 6 cases. MR signal uneven in 7 cases, uniform in 2 cases. In the 9 cases of dynamic contrast-enhanced ultrasound, there were 8 cases with progressive enhancement of degeneration, the junction of skin and spinal cord, mild enhancement of parenchyma, and 1 case of moderate enhancement. The renal pelvis enhancement was similar to that of parenchyma. Histopathological type Ⅰ in 7 cases, Ⅱ type in 2 cases. Conclusions Papillary renal cell carcinoma has some MR features. The dynamic enhancement can provide more diagnostic information.