目的 探讨肾上皮样血管平滑肌 脂肪瘤患者的CT增强扫描表现及特点。方 法 回顾性分析2010年1月至2017年6月我 院就诊的13例肾上皮样血管平滑肌脂肪瘤 患者的临床及影像学资料，结合其特点， 再复习国内外相关文献，探讨其CT增强扫 描特点。结果 5例患者术前误诊为肾癌， 4例术前诊断正确，4例在鉴别诊断中提到 该病，临床表现主要为腹痛、腹部不适 或体检发现。4例较大肿块含明显脂肪成 分表现为混杂密度，9例患者CT平扫均呈 等或稍高密度，4例三维重建显示病灶呈 “楔征”，9例患者强化方式为“快进慢 出”型，4例为“快进快出”型，5例强化 相对较均匀，9例强化不均匀。结论 肾上 皮样血管平滑肌脂肪瘤术前诊断准确性 低，临床表现无特异性，影像学表现与肾 癌难以鉴别，但当病灶CT平扫表现为等或 稍高密度，三维重建形态呈“楔征”，增 强扫描呈“快进慢出”型，强化程度较均 匀时，应考虑到本病的可能。

Objective To investigate the characteristics of CT enhancement scanning in patients with renal epithelioid angiomyolipoma. Methods Retrospective analysis of clinical and imaging data of 13 cases of renal epithelioid angiomyolipoma patients from January 2010 to June 2017, Review the relevant literature，To discuss the features of CT enhanced scanning image. Results 5 patients were misdiagnosed as renal cancer before surgery, 4 patients were correct before surgery, and 4 patients were diagnosed in the differential diagnosis. Clinical manifestations included abdominal pain, abdominal discomfort or physical examination.4 cases of larger tumors displayed as mixed density because it's contain a lot of fat , 9 cases of patients with CT for isodensity or slightly high density, 4 cases showed as "wedge" after three-d reconstruction, 9 caese were improved way as the "fast in slow out" type, 4 cases were improved way as the "fast forward fast" type, 5 cases of reinforcement are relatively uniform, 9 cases of strengthen the uneven. Conclusion The renal epithelioid angiomyolipoma is prone to misdiagnosis before surgery and has no specific clinical manifestations,Imaging findings is difficult to identify with kidney cancer,But when lesions on CT scan showed isodensity or slightly high density, 3 d reconstruction showed "wedge", enhanced scanning type is "fast in slow out", strengthen the extent is uniform, We should consider this disease.