2008, Vol. 19 Issue (7): 478-480    DOI:
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肾盂癌的MRI诊断及评价
关 键,胡道予,夏黎明,张 伶,方 磊
华中科技大学同济医学院附属同济医院放射科,湖北 武汉 430030
Diagnostic value of MR imaging in renopelvic carcinoma
GUAN Jian, HU Dao-yu, XIA Li-ming, ZHANG Ling, FANG Lei
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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摘要 目的:分析肾盂癌的MRI表现,评价MRI的诊断价值并比较各序列的诊断意义。方法: 搜集资料完整并经病理证实的肾盂癌13例,行T1WI、T2WI、STIR、FIESTA轴位和/或冠状位扫描,其中6例行MRI增强扫描,2例行磁共振尿路水成像(MRU)。结果: MRI扫描示病灶大小为0.6cm×0.8cm~3.5cm×4.0cm。9例为局限型,表现为腔内肿块影,边界较清晰,肾窦脂肪受压向四周呈不同程度的移位。浸润型4例,肿瘤向肾实质内呈偏心性侵犯,肾轮廓轻到中度变形。合并肾积水3例,肾囊肿4例。MRI分期:Ⅰ~Ⅱ期7例,Ⅲ期3例,Ⅳ期3例。T1WI为均匀低信号7例,混杂信号2例,均匀等信号4例;T2WI为均匀略高信号6例,混杂高信号2例,等信号5例。6例增强扫描者,均匀强化4例,不均匀强化2例,5例病灶强化相对肾实质肿瘤呈低信号,1例增强后信号高于周围肾实质。2例MRU均未见明显异常。病理检查均为尿路移行上皮癌,病理分期:Ⅰ期0例,Ⅱ期6例,Ⅲ期4例,Ⅳ期3例。结论:MRI能较准确检出肾盂癌,冠状位扫描有利于发现和观察病灶,应作为常规序列。增强扫描有助于明确诊断。MRU并非必需扫描序列。MRI多种序列的结合分析有利于肾盂癌的定位及分期。
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关键
胡道予
夏黎明
张伶
方磊
关键词 肾肿瘤肾盂磁共振成像     
AbstractObjective: To study the MRI manifestations of renopelvic carcinoma and to evaluate the diagnostic value of MRI. Methods: Thirteen surgically and pathologically proved cases of renopelvic carcinoma were examined with MRI pre-operation. All the cases were scanned with T1WI, T2WI, STIR and FIESTA sequences on axial and/or coronal position. Enhancing scans were performed in 6 cases. Two patients received MRU scan. Results: In these 13 cases, the size of lesions were between 0.6cm×0.8cm to 3.5cm×4.0cm on MRI. The lesions were limited mass in renal pelvis with clear borderline in 9 cases. In the other 4 cases, the lesions showed invasive growth and adjacent renal parenchyma was involved. Hydronephrosis and renal cysts were showed in 3 cases and 4 cases respectively. The lesions belonged to Ⅰ~Ⅱ stage(n=7), Ⅲ stage(n=3) and Ⅳ stage(n=3) by MRI staging. On T1WI, the lesions presented as homogeneous hypointense signal masses in 7 cases, heterogeneous signal intensity in 2 cases, isointense signal intensity in 4 cases. On T2WI, the lesions presented as homogeneous hyperintense signal in 6 cases, inhomogeneous hyperintense signal in 2 cases and isointense signal intensity in 5 cases. Homogeneous enhancement was presented in 4 cases, while inhomogeneous enhancement in 2 cases in cortical phase. Intensity of enhancement was mildly raised in 5 cases in parenchymal and pyelographic phases. There were no abnormal manifestations on MRU. The cases belonged to Ⅰ stage(n=0), Ⅱ stage(n=6), Ⅲ stage(n=4) and Ⅳ stage(n=3) by histopathology staging. All the cases were transitional cell carcinoma. Conclusion: Renopelvic carcinoma can be detected accurately by MRI. Coronal MRI is helpful for diagnosis. MRU is an alternative method and not essential in fact.
Key wordsKidney neoplasms    Kidney pelvis    Magnetic resonance imaging
收稿日期: 2008-01-15     
:  R737.11  
  R445.2  
引用本文:   
关 键;胡道予;夏黎明;张 伶;方 磊. 肾盂癌的MRI诊断及评价[J]. , 2008, 19(7): 478-480.
GUAN Jian;HU Dao-yu;XIA Li-ming;ZHANG Ling;FANG Lei. Diagnostic value of MR imaging in renopelvic carcinoma. , 2008, 19(7): 478-480.
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