肾脏交织状血管瘤影像学表现：附１例报告并文献复习

The Imaging Manifestations of Renal Anastomosing Hemangioma: A Case Report and Literature Review

摘要: 目的：探讨肾脏交织状血管瘤的临床特点及影像学表现，提高对该病的诊断及治疗。方法：回顾性分析1例肾脏交织状血管瘤的临床资料及患者术前接受的CT和MRI检查，后接受腹腔镜下根治性肾脏切除术。结合相关文献复习，总结该病的影像诊断和治疗特点。结果：CT检查：平扫肿块呈类圆形低密度灶，边界清晰，增强扫描呈不均匀强化，髓质期及排泄期强化范围增大，呈向心性延迟强化表现；MRI检查：T1WI呈等、低信号，T2WI呈不均匀稍高及高信号影，DWI (b = 800)病变边缘区局部呈稍高信号，相应ADC信号略低，增强扫描强化方式与CT强化相似；最终行后腹腔镜下左侧肾根治性切除术，术后病理结果为肾交织状血管瘤。结论：肾脏交织状血管瘤是一种肾脏罕见的良性肿瘤，影像表现及临床特点无特异性，易误诊为恶性肿瘤，导致过度诊断及治疗，因此我们需要提高认识以完善诊断和治疗方法。

Abstract: Objective: To explore the clinical characteristics and imaging manifestations of renal anastomosing hemangioma, and to improve the diagnosis and treatment of this disease. Methods: A retrospective analysis was conducted on the clinical data of 1 case of renal anastomosing hemangioma and the CT and MRI examinations the patient underwent before surgery. The patient received radical nephrectomy via retroperitoneal laparoscopy. Combined with a review of relevant literature, the diagnostic and therapeutic characteristics of this disease were summarized. Results: CT examination revealed a round-like, low-density mass with clear boundaries on plain scan. Enhanced scans showed heterogeneous enhancement, with increased enhancement during the medullary and excretory phases, showing a centripetal delayed enhancement pattern. MRI examination revealed isointense and low signal on T1WI, and heterogeneous slightly high and high signals on T2WI. DWI (b = 800) showed slightly high signals in some areas of the lesion margin, with slightly lower corresponding ADC signals. The enhanced scanning enhancement pattern was similar to that of CT. Eventually, radical nephrectomy of the left kidney was performed via retroperitoneal laparoscopy, and the postoperative pathological result was renal anastomosing hemangioma. Conclusions: Renal anastomosing hemangioma is a rare benign renal tumor with nonspecific imaging and clinical features, often misdiagnosed as a malignant tumor, leading to overdiagnosis and overtreatment. Therefore, increased awareness is necessary to refine diagnostic and therapeutic approaches.