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1、腎臟嗜酸細(xì)胞腺瘤的螺旋CT診斷與病理對照分析【摘要】目的：分析腎嗜酸細(xì)胞瘤的多排螺旋CT增強(qiáng)掃描特征及病理表現(xiàn)，以提高診斷準(zhǔn)確性。方法：對12例經(jīng)手術(shù)后病理證實(shí)的腎嗜酸細(xì)胞腺瘤患者的多期增強(qiáng)CT影像學(xué)特點(diǎn)及病理結(jié)果進(jìn)行回顧性分析。結(jié)果：11例為單發(fā)病灶，1例為多發(fā)病灶。病灶最大徑20.0?87.0mm,平均53.5mmo1例行CT平掃顯示腫瘤實(shí)質(zhì)呈略高密度影，中心瘢痕呈低密度影。皮質(zhì)期5例不均勻強(qiáng)化，6例腫瘤實(shí)性部分較均勻強(qiáng)化，所有病灶強(qiáng)化程度均高于髓質(zhì)，低于皮質(zhì)；實(shí)質(zhì)期病灶強(qiáng)化程度均低于髓質(zhì)，2例欠均勻強(qiáng)化，10例病灶密度趨向均勻強(qiáng)化；延遲期腫瘤實(shí)性部分整體密度較均勻強(qiáng)化并低于
2、腎實(shí)質(zhì)，與病理上該腫瘤較少發(fā)生出血、壞死、囊變相對應(yīng)。其中1例雙腎多灶病變亦遵循上述強(qiáng)化方式。6例見中央裂隙狀或星芒狀瘢痕，所有病例均未見鈣化。結(jié)論：腎嗜酸細(xì)胞瘤是一種少見的腎臟良性腫瘤，多期螺旋CT增強(qiáng)掃描有一定影像學(xué)特點(diǎn)，如果能在術(shù)前提示到本病的可能性，可采取腎穿刺活檢或手術(shù)中冰凍病理活檢，對臨床手術(shù)治療方案的制定有重要參考意義。【關(guān)鍵詞】腎嗜酸細(xì)胞腺瘤；診斷；螺旋CT；病理TheComprehensiveDiagnosisofRenalOncocytomabySpiralCTandPatho1ogy/ZHANGQing,LIJun~tang,ZHANGJin-feng,et
3、al.//MedicalInnovationofChina,2015,12(10)：124-129[Abstract]Objective：ToanalyzetheproblemsindiagnosingrenaloncocytomabyspiralCTandpathology，inordertoimprovetheaccuracyofdiagnosis.Method：TheimagingfeaturesofCTof12lesionsconfirmedbypathologywereanalysedretrospectivelyandcorrelatedbypathologicdia
4、gnosis.ResuIt：11casesweresinglenodule,accompanyingwiththediameteroflesionwas20-87.0mm,average53.5mm.ONplainCTsean,1lesionshowedalittlehigherdensitythantherenalparenchyma*centralstellatescarshowedlowdensityshadow?Inthecorticalphase,5casesdisplayedinhomogeneousenhancement,and6casesdisplayedhomo
5、geneousenhancementinpart.Theenhanceddegreeofalllesionswerehigherthanthatofmedulla,andlowerthanthatofcortex.Inparenchymalphase,theenhanceddegreeofalllesionswerelowerthanthatofmedulla?Inexcretoryphase,thedensityofsolidpartoftumorwasequation,andbelowthatoftherenalparenchyma,whichwascorresponding
6、withthepathologicalfeature：thetumorwaslessofhemorrhage,necrosisandcysticdegeneration.Thecaseofbilateralmultiplerenallesionsalsofollowedthestrengtheningmethod.6casesshowedcentralslitshapedorstellateshapedscar,andallcasesshowednocalcification.Conclusion：Sincerenaloncocytomaisakindofbenignrenalt
7、umor,whichhassomeimagingfeaturesinenhancedspiralCTsean,takingrenalbiopsybeforeoperationorsurgeryfrozenbiopsywillbeusefultomaketherapyplanforthebenefitsofpatients.[Keywords]Renaloncocytoma；Diagnosis；SpiralCT；PathologyFirst-author?saddress：Qing
