【摘要】 目的 探讨血供丰富的肾错构瘤的螺旋CT表现及治疗。方法 回顾性分析12例经手术病理证实的多血供肾错构瘤的螺旋CT表现及治疗方法，并与病理进行对照研究。结果 12例中，4例CT片上看不到脂肪密度，8例可见到散在小斑块状脂肪密度。增强扫描全部肿瘤于肾皮质期明显强化，肾实质期肿瘤强化减退。12例均行手术切除，其中9例行肿瘤剜除术，3例因瘤体大、严重累及肾实质和肾窦而行一侧肾切除术。结论 血供丰富的肾错构瘤螺旋CT增强扫描往往表现为快进快出这种一过性明显强化方式，当瘤内看不到脂肪密度时应注意与多血供肾癌鉴别。由于血供丰富的肾错构瘤生长快且易破裂出血，所以当影像发现肾错构瘤供血丰富时，即使瘤体小、无症状，亦应建议临床及早手术切除。

    【关键词】 肾脏；错构瘤；体层摄影术；X线计算机；外科学

    Renal hamartomas with plenty of blood: the study of manifestations of spiral CT and its treatment

    GUO Yan,LIU Ming-juan,PENG Qian,et al.

    Department of Radiology,First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China

    【Abstract】 Objective To evaluate the manifestations of the spiral CT and the treatment of renal hamartomas with plenty of blood.Methods The spiral CT findings and the treatment in 12 cases of hypervascular renal hamartomas with histopathologically proved were analyzed,and contrasted with pathology retrospectively.Results No fat nature could be detected on CT scan in 4 of the 12 cases.In another 8 of the 12 cases,fat attenuation in spots were detected.After the administration of intravenous contrast material,all cases enhanced obviously in corticomedullary phase and decreased in attenuation during nephrographic phase.All cases received operations.Among them,9 cases had enucleations,3 cases had resections with tumor and residual kidney on account of huge tumor and seriously damaged kidney.Conclusion Renal hamartomas with plenty of blood always manifest transient hyperattenuating after the administration of intravenous contrast material.They should be differentiated from hypervascular renal carcinoma when no fat attenuation is detected on CT.Because hypervascular renal hamartomas grow fast and rupture easily with bleeding,they should be removed as soon as possible although the tumors are small or asymptomatic. ......