Department of Radiology, New York University Langone Medical Center, 560 First Ave., TCH-HW202, New York, NY 10016, USA.
AJR Am J Roentgenol. 2010 Dec;195(6):W421-7. doi: 10.2214/AJR.10.4718.
The purpose of this study was to retrospectively describe the MRI features of the pathologically related entities renal oncocytoma and chromophobe renal cell carcinoma (RCC).
Twenty-eight cases of histologically proven renal oncocytoma and 15 of chromophobe RCC evaluated with preoperative MRI from January 2003 through June 2009 at our institution were independently reviewed for an array of MRI features by two radiologists blinded to the final histopathologic diagnosis. These features were tabulated and compared between chromophobe RCC and renal oncocytoma by use of the Mann-Whitney test and binary logistic regression.
Renal oncocytoma and chromophobe RCC showed no significant difference in size or any of 16 qualitative imaging features (p = 0.0842-1.0, reader 1; p = 0.0611-1.0, reader 2). Microscopic fat, hemorrhage, cysts, infiltrative margins, perinephric fat invasion, renal vein invasion, enhancement homogeneity, and hypervascularity were each observed in less than 20% of cases by both readers. A central scar and segmental enhancement inversion (a recently described finding in which early contrast-enhanced images show relatively more enhanced and less enhanced intralesional components with inversion of their relative enhancement on later images) were observed by both readers in at least 10% of cases of both renal oncocytoma and of chromophobe RCC with no significant difference between the two entities (p = 0.2092-0.2960).
We have presented the largest series to date of the MRI features of both renal oncocytoma and chromophobe RCC. These related entities exhibited similar findings, and no MRI features were reliable in distinguishing between them.
本研究旨在回顾性描述与病理相关的实体肾嗜酸细胞瘤和嫌色细胞肾细胞癌（RCC）的 MRI 特征。
回顾性分析 2003 年 1 月至 2009 年 6 月期间我院经病理证实的 28 例肾嗜酸细胞瘤和 15 例嫌色细胞 RCC 患者的术前 MRI 资料，由 2 名放射科医生独立评估一系列 MRI 特征，两位放射科医生在评估时均不知道最终的组织病理学诊断。这些特征通过 Mann-Whitney 检验和二项逻辑回归进行制表并在嫌色细胞 RCC 和肾嗜酸细胞瘤之间进行比较。
肾嗜酸细胞瘤和嫌色细胞 RCC 在大小或 16 种定性成像特征上无显著差异（p = 0.0842-1.0，读者 1；p = 0.0611-1.0，读者 2）。两位读者均观察到不到 20%的病例存在微小脂肪、出血、囊肿、浸润性边缘、肾周脂肪侵犯、肾静脉侵犯、增强均匀性和富血管性。中央瘢痕和节段性增强反转（一种最近描述的发现，在这种发现中，早期增强图像显示相对更多增强和较少增强的病灶内成分，并且其相对增强在后期图像中反转），两位读者均观察到至少 10%的肾嗜酸细胞瘤和嫌色细胞 RCC 病例中存在这种情况，两种实体之间无显著差异（p = 0.2092-0.2960）。
我们目前已经提出了迄今为止关于肾嗜酸细胞瘤和嫌色细胞 RCC 的最大系列 MRI 特征。这些相关实体表现出相似的表现，没有任何 MRI 特征可用于可靠地区分它们。
