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目的 :探讨肾血管平滑肌脂肪瘤 (错构瘤 )的诊断治疗方法。方法 :回顾分析 2 2例肾错构瘤的临床资料。结果 :B超诊断符合率 5 4.5 % ,CT为 81.8% ,术前诊断错构瘤 18例 ,误诊为肾癌 4例 ,其中 3例术中冰冻切片示错构瘤 ,行肿瘤剜除 11例 ,肾部分切除 7例 ,肾切除 3例 ,肾根治性切除 1例。结论 :CT是诊断错构瘤的首选检查手段 ,肿瘤体积大小、脂肪含量少、瘤内出血是影像学改变不典型导致误诊的原因 ,仔细分析病史、影像学资料及术中冰冻切片可避免误诊 ,手术治疗应尽量采用保留肾脏的手术。
Objective: To investigate the diagnosis and treatment of renal angiomyolipoma (hamartoma). Methods: The clinical data of 22 cases of renal hamartoma were retrospectively analyzed. Results: The coincidence rate of B ultrasound diagnosis was 54.5% and CT was 81.8%. There were 18 cases of hamartoma preoperatively diagnosed and 4 cases of misdiagnosis as renal cell carcinoma. Three cases of intraoperative frozen section showed hamartoma and 11 cases of tumor eradication , Partial nephrectomy in 7 cases, nephrectomy in 3 cases and radical nephrectomy in 1 case. Conclusions: CT is the first choice for the diagnosis of hamartoma. Tumor volume, fat content and intratumoral hemorrhage are the causes of misdiagnosis of atypical radiological changes. Careful analysis of medical history, imaging data and intraoperative frozen sections can avoid misdiagnosis, Surgical treatment should be used to retain the kidney surgery.