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目的 探讨低度恶性潜能多房囊性肾肿瘤(MCRNLMP)的CT影像特点。方法 回顾性分析我院2018年12月—2024年8月10例经手术病理证实为MCRNLMP的患者资料，所有患者均有完整的术前CT平扫及多期增强扫描资料，其中4例同期行MR平扫及增强扫描，分析总结其CT及MRI影像特点。结果 10例均表现为肾实质内多房囊性肿块，肿物呈规则类圆形或分叶状，长径34～72 mm，中位直径40 mm。囊性部分呈大小不等分隔囊腔，囊腔数大于5；囊壁及囊内分隔厚度欠均匀，3例可见钙化。肾肿物实性部分占比均不超过15%，表现为增厚和/或不规则的分隔，无明确结节。按照Bosniak分级，肿物分为ⅡF级1例，Ⅲ级2例，Ⅳ级7例。4例MRI平扫肿物囊壁及分隔T_1WI呈稍低或等信号，T_2WI呈等或稍高信号。增强扫描病灶分隔及实性成分呈轻-中度持续强化或明显持续强化；均未见周围组织侵犯及转移表现。镜下病灶呈多房囊性结构、缺乏实性或膨胀性生长区域。结论 MCRNLMP CT表现有一定特点，按照Bosniak分级并重点观察其实性成分，有助于适当的治疗方案。
Abstract：Objective To investigate the CT imaging features of multilocular cystic renal neoplasm of low malignant potential(MCRNLMP). Methods A retrospective analysis was conducted on 10 patients with pathologically confirmed MCRNLMP treated at our institution between December 2018 and August 2024. All 10 patients underwent plain and multi-phase contrast-enhanced CT, and 4 also underwent plain and contrast-enhanced MRI. The CT and MRI characteristics were analyzed and summarized. Results All 10 tumors were manifested as multilocular cystic masses within the renal parenchyma. The lesions were round or lobulated with a long axis ranging from 34 to 72 mm(median diameter: 40 mm). The tumors consisted of more than 5 septated cystic locules varying in size and thickness of the cyst and septal walls. Punctate or linear calcifications were observed within the walls/septa in 3 cases. Solid components constituted no more than 15% of the tumor volume presenting as thickened and/or irregular septa without definite nodules in all patients. The cystic lesions were categorized as Bosniak type IV(7), III(2) and IIF(1). MRI in4 patients showed T1-isointense or slightly hypointense and T2-isointense or slightly hyperintense tumor walls and septa with mild-to-moderate or marked persistent contrast enhancement. No local invasion or distant metastasis was identified in any patient.Histopathological examination confirmed multilocular cystic architecture without solid or expansile growth areas in all tumors.Conclusion Applying the Bosniak classification system with particular emphasis on the evaluation of solid components on CT can aid diagnosis and management of MCRNLMP.
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基本信息:
中图分类号:R737.11;R730.44
引用信息:
[1]罗林辉,卢伟光,赖焕泉,等.低度恶性潜能多房囊性肾肿瘤CT表现分析[J].影像诊断与介入放射学,2025,34(06):389-394.