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目的:探讨乏脂肪肾血管平滑肌脂肪瘤(AML)的多排螺旋CT(MSCT)和MR化学位移成像(CSI)表现及病理基础,旨在提高对该病诊断的准确率。方法:回顾性分析经病理证实的16例乏脂肪肾AML患者的MSCT和MRI资料,分析病灶的大小、形态、密度、增强血供情况及CSI表现,并与手术病理结果对照。结果 16例病灶均表现为实质性肿块,10例病灶呈类圆形,6例病灶呈不规则形,9例病灶见劈裂征,6例见杯口征,5例见皮质掀起征,11例病灶CT平扫呈稍高密度,其中4例密度不均匀,内见小灶性低密度。增强扫描病灶呈快进快退、持续强化和延迟强化三种模式,但峰值强化程度均低于肾皮质。MR成像T2WI病灶均呈低信号,CSI中3例出现反相位信号下降,其中1例呈现反相位病灶中心高信号,周围绕以线状低信号环的特殊表现。结论:乏脂肪肾AML的MSCT和MRI表现有一定特征性,薄层MR反相位CSI对该病诊断有较高的价值。
Objective: To investigate the multi-slice spiral CT (MSCT) and MR chemical shift imaging (CSI) manifestations and pathological basis of non-fat angina angiomyolipoma (AML) in order to improve the diagnostic accuracy of the disease. Methods: The MSCT and MRI data of 16 AML patients confirmed by pathology were retrospectively analyzed. The size, shape, density, blood supply and CSI of the lesions were analyzed. The results were compared with the pathological findings. Results All the 16 lesions showed substantial mass, 10 lesions were round, 6 lesions were irregular, 9 lesions were seen splitting sign, 6 lesions were seen in the mouth, 5 were found in the cortex, 11 Cases of CT scan showed a slightly higher density, of which 4 cases of uneven density, see within the focal low density. Enhanced scan lesions were fast forward and rewind, continuous enhancement and delayed enhancement of the three modes, but the intensity of peak enhancement were lower than the renal cortex. MR imaging of T2WI lesions showed low signal, CSI in 3 cases of anti-phase signal decreased, including 1 case of anti-phase center lesions with high signal around the linear low-signal ring around the special performance. Conclusion: MSCT and MRI findings of AML patients have certain characteristics. The thin-layer MR anti-phase CSI has high value in the diagnosis of AML.