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目的:分析各种含囊性成分的肾脏肿瘤的综合影像学特点,提高诊断和鉴别水平。方法:回顾性分析了29例经病理证实的含囊性成分的肾脏肿瘤的B超、CT和MR表现,观察病灶的部位、形态、密度、回声及信号特点。结果:29例患者中有肾癌囊性变15例(14例为透明细胞癌、1例为乳头状肾癌),表现为病灶内部密度和回声不均匀,增强后不均匀明显强化,6例(40%)病灶周围可见有包膜;囊性肾癌5例(均为透明细胞癌),3例(60%)有明显壁结节,增强后结节明显强化,2例(40%)为多房性,增强后分隔有强化;囊性肾瘤4例,均为多房性,房间隔较薄而均匀,增强后间隔有强化;囊肿伴感染5例,均表现为圆形病灶,形态规则,壁厚而均匀,增强后囊壁轻度强化。各项检查诊断准确率依次为:B超检查(52.6%,10/19),CT检查(62.5%,15/24),MR检查(54.5%,6/11);3项检查诊断准确率之间进行两两比较,均无显著差别(P>0.05)。结论:对含囊性成分的肾脏肿瘤影像学诊断和鉴别较为困难。综合B超、CT和MR的影像学表现,有助于对其术前诊断与鉴别。
OBJECTIVE: To analyze the comprehensive imaging characteristics of various renal tumors with cystic components and to improve the diagnostic and differential levels. Methods: A retrospective analysis of 29 cases of pathologically confirmed cystic components of renal tumors by B ultrasound, CT and MR findings, the location of the lesion, morphology, density, echo and signal characteristics. Results: Among the 29 patients, there were 15 cases of cystic degeneration of renal cell carcinoma (14 cases of clear cell carcinoma and 1 case of papillary renal cell carcinoma). The density and echoes of lesions were nonuniform, (40%) showed envelopment around the lesion; cystic renal cell carcinoma in 5 cases (all clear cell carcinoma), 3 cases (60%) had obvious wall nodules, enhanced nodules were significantly enhanced in 2 cases For the multi-ventricular enhanced enhanced separation; 4 cases of cystic renal disease, are multi-ventricular septal thinner and uniform, enhanced after enhanced septum; 5 cases of cyst with infection, showed round lesions, Morphology rules, wall thickness and uniformity, enhanced mild enhancement of posterior capsule wall. The diagnostic accuracy of each examination were as follows: B ultrasound examination (52.6%, 10/19), CT examination (62.5%, 15/24), MR examination (54.5%, 6/11) Between any two comparisons, no significant difference (P> 0.05). Conclusion: It is difficult to diagnose and differentiate renal tumor with cystic components. Comprehensive B-ultrasound, CT and MR imaging findings, contribute to their preoperative diagnosis and identification.