目的通过CT扫描探讨血供充足 乏脂肪肾脏错构瘤的特点，提高鉴别其与 肾透明细胞癌的诊断准确率。方法 回顾 性分析我院24例术后证实的血供充足的乏 脂肪肾脏错构瘤患者(共25个肿瘤)并进行 病理学比较研究。结果 本组24例错构瘤 的患者均未出现血尿。96例确诊为肾透明 细胞癌的患者，14例有血尿(14.6%)。CT 扫描分析显示，20例肿瘤具有类似的密 度，其中5例密度较高，1例有少量钙化点 (4%)，9例未见脂肪组织，16例经CT扫描 可见脂肪组织斑点；增强扫描显示所有肿 瘤肾皮髓期明显增强，20例肿瘤早期明显 不均匀强化，另5例均匀延迟增强；19例 患者手术移除错构瘤，6例患者由于误诊 为肾癌，导致单侧肾移除，肿瘤严重累及 肾实质及肾窦；经病理分析，25例属于肾 错构瘤，96例肾透明细胞癌患者中，64例 肿瘤密度相对较低，29例等密度，3例较 高密度；14例钙化(14.6%)，未见脂肪组 织。CT增强扫描表明，69例肾癌表现为肾 皮髓质期显著强化，呈“快进快出”异常 模式。此外，27例表现为缓慢延迟增强。 结论 通过薄层CT确定脂肪组织的位置有 利于鉴别血供充足乏脂肪肾脏错构瘤与肾 透明细胞癌。

Objective To investigate the features of minimal fat renal angiomyolipoma with sufficient blood supply by CT scan and to improve the diagnostic accuracy in differentiating it from clear cell renal carcinoma. Methods 24 cases of patients with postsurgery confirmed angiomyolipoma with sufficient blood supply (total of 25 tumors) in our hospital were retrospectively analyzed and were pathologically compared and studied. Results Among the 24 patients diagnosed with angiomyolipoma, there was no patients with bloody urine. Of the 96 patients diagnosed with clear cell renal cancer, 14 had bloody urine (14.6%). CT scan analysis showed 20 tumors were of similar density, and 5 of them were of higher density. Only one tumor had a few dots of calcification (4%). CT scan showed thaty adipose tissue was not visible in 9 tumors, while 16 tumors had visible dots of adipose tissue. Intensive scanning indicated that all of the tumors showed a strong enhancement in the renal corticomedullary phase. 20 tumors had significant heterogeneous enhancement in the early phase, while another 5 cases had homogenous prolonged enhancement. 19 patients had surgery to remove the angiomyolipomas, while 6 patients had single side kidney removal because of misdiagnosis for renal cancer and the renal parenchyma and sinus were severely compromised by tumors. 25 cases were classified as renal angiomyolipoma by pathological analysis. Within the 96 cases of clear cell renal cancer, 64 tumors were of relatively low density, 29 tumors of equal density, and 3 cases of relatively higher density. 14 of the tumors had calcification (14.6%), and none of them had visualized adipose tissue. Enhanced CT scans indicated that 69 cases of renal cancer showed significant enhancement in the renal corticomedullary phase, with the abnormal pattern of "fast-in-and-fast-out". Besides, 27 cases had slow and prolonged enhancement. Conclusion The key to differentiating them is to identify the adipose tissue within the tumor. Therefore, it is helpful to use thin-layer CT scans to locate the adipose tissue.