乳头状肾细胞癌MRI分析

目的：探讨乳头状肾细胞癌的MRI表现及特点。材料及方法：回顾性分析10例经手术病理证实的乳头状肾细胞癌MRI表现。回顾性阅读手术记录及病理报告单，并将结果与MRI表现对照。结果：肿瘤信号不均匀（9/10，90％）；T1WI 6例呈混杂信号，4例呈中低信号；T2WI及T2WI/SPIR肿瘤信号相仿，9例呈混杂信号，1例T2WI及T2WI/SPIR呈低信号；轻度强化6例（60％），中度强化4例（40％）。4例实性肿瘤为不均匀强化，1例均匀轻度强化。病理上，5例肿瘤完全呈囊性（3例）或部分区域有囊性变（2例），其中4例囊液内可见不同程度不同时期出血；5例肿瘤呈实性，4例内部伴出血及坏死灶。结论：乳头状肾细胞癌的MRI表现较有特点，对肾细胞癌亚型诊断与鉴别诊断有一定帮助。

MR imaging of papillary renal cell carcinoma

Objective: To analyze and discuss the appearance and specificity of papillary renal cell carcinoma(RCC) using magnetic resonance imaging. Materials and Methods: Ten patients(10 lesions; 6 female, 4 male; mean age 53 years) with pathologically proved papillary RCC were reviewed retrospectively. MR imaging was performed with a 0.5T imaging unit(Philips) by using body coil. T1-weighted imaging(T1WI), T2-weighted imaging(T2WI), T2-weighted imaging with spectral presaturation with inversion recovery(T2WI/SPIR) images and Gd-T1WI/3D images were obtained in all patients. Result: All of the tumors except one(9/10, 90%) showed heterogeneous hyper-intense than the unaffected renal cortex on their T2WI or T2WI/SPIR; six tumors showed heterogeneous mixed intense and four tumors showed homogeneous iso-intense in their T1WI than the unaffected renal cortex. Six tumors showed mild enhancement and four showed moderate enhancement on contrast enhanced scans. Cystic renal carcinoma(3 cases) and cystic degeneration(2 cases) were found in five cases pathologically, the other five cases showed solid tumors, hemorrhage and necrosis were found in 8 cases. Conclusion: There were some characteristics in the MRI appearance of papillary renal cell carcinoma, and these characteristics may be helpful in predicting a specific subtype of renal cell carcinoma.