期刊
EUROPEAN RADIOLOGY
卷 26, 期 2, 页码 592-600出版社
SPRINGER
DOI: 10.1007/s00330-015-3851-8
关键词
Angiomyolipoma; Ultrasound; Computed tomography; Magnetic resonance imaging; Fat
Objectives To compare imaging findings with histopathology in AML without visible fat (AML(wvf)). Methods With IRB approval, we identified 18 AML(wvf) that underwent CT between 2002-2014. A radiologist measured NECT-attenuation, corticomedullary (CM) and nephrographic (NG) enhancement, echogenicity relative to renal cortex (RC) (N = 5), T2W (T2(AML)/T2(RC)) signal-intensity (SI), and chemical-shift SI ([SIIN-PHASE SIOPPOSED-PHASE]/SIIN-PHASE) indices (N = 6). A pathologist re-evaluated 15/18 AML(wvf) for 1)< or > 25 % adipocytes/high-power-field (HPF), 2) many or few blood vessels. Comparisons were performed using chi-square and independent t-tests. Results 73.3 %(11/15) of AML(wvf) had < 25 % adipocytes/HPF and 86.7 %(13/15) had many blood vessels. NECT-attenuation was 41.8(+/- 6.9) HU. 61.1 %(11/18) of AML(wvf) were hyper-attenuating and 38.9 %(7/18) iso-attenuating; attenuation was associated with %-adipocytes/HPF, (p = 0.01). CM/NG enhancement were 63.3(+/- 20.8)/51.7(+/- 15.5) HU. 72.2 %(13/18) of AML(wvf) had wash-out enhancement, with no association with amount of blood vessels at pathology, (p = 0.68). No difference in echogenicity was noted by histology (p > 0.05). All AML(wvf) were T2-hypointense (SI ratio = 0.61 [+/- 0.1]). 2/6 AML(wvf) showed SI drop on chemical-shift MRI; both were iso-attenuating and were associated with > 25 % adipocytes/HPF (p = 0.04). Conclusions AML(wvf) are typically T2-hypointense and hyper-attenuating with wash-out enhancement due to abundant smooth muscle and vessels respectively. Iso-attenuating AML(wvf) with microscopic fat on MRI contain more adipocytes/HPF.
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