肾肿瘤基础医学医药卫生专业资料ppt课件.ppt

Characterizing solid renal neoplasms with MRI in adults 成人实性肾肿瘤的MRI特征 Introduction In order to accurately classify a solid renal neoplasm, a systematic approach is recommended, including attention to clinical and laboratory data, lesion location and number, lesion signal intensity and composition, enhancement pattern, and diffusivity. Because no single feature in isolation is definitively diagnostic of a particular type of neoplasm, the individual characteristics of a renal mass must then be combined to narrow the differential diagnosis or suggest a most likely histology. 为了准确的鉴别实性肾肿瘤，在此推荐一种系统的方法，包括临床和实验室数据、病变位置和数量、病变信号强度和成分、强化类型及弥散情况。由于没有某个单独的特称可用于诊断某一类型的肿瘤，因此肾脏肿瘤的多种特征必须结合起来缩小鉴别诊断的范围或者推断出最为可能的组织学类型。 Imaging protocol 成像序列 MR imaging is generally performed with a phased-array body coil with the patient supine. A typical renal MRI protocol begins with a coronal localizer using a fast sequence such as single-shot turbo/fast spin echo. This provides an anatomic overview of the abdomen and allows depiction of contour abnormalities at the renal poles. Axial dual gradient-echo T1-weighted (in-phase and opposed-phase) imaging is performed with the longer echo time (TE) assigned to the in-phase echo. In-phase and opposed-phase imaging allows detection of fat and intracytoplasmic lipid/glycogen or hemosiderin within renal masses. MRI扫描通常体线圈，病人仰卧位。扫描序列包括首先扫描的冠状位，提供了腹部的解剖概况并发现肾脏外形的异常。T1WI（正、反相位）可监测肿块内的脂肪、胞浆内的脂类/糖原或含铁血黄素。 These components can provide clues regarding the benign or malignant nature of a solid renal mass or provide a hint as to the subtype of RCC. Subtle changes in signal intensity between in- and opposed-phase images can often be better appreciated with subtraction imaging. If a Dixon method is used, ‘‘fat-only’’ and ‘‘water-only’’ images will be automatically generated and can also be helpful in identifying regions of microscopic and macroscopic fat. 这些信息可以提供良恶性肿块的线索或者肾细胞癌亚型的提示。正反相位中信号强度的微小变化可以在减影图中更好的显示。如果使用的是“Dixon”成像，“脂像”和“水像”可以自动生成，这也有助于确定局部微观和宏观的脂肪成分。 50岁男性