摘要
含脂肪成份的腎臟腫瘤(lipomatous tumors)是腎實質最常見的良性腫瘤，其中以血管肌肉脂肪瘤(angiomyolipoma)最多，在超音波和電腦斷層被廣泛應用後，更能於開刀前正確診斷這種疾病，尤其更多無症狀的腎臟脂肪腫塊於常規掃描時被意外發現，治療也從全部腎臟切除變成更保守療法。脂肪結構的超音波掃描可因成份和構造而成不等度的回波反射，但於腎臟皮質則呈高回音狀，因此和低度回音之皮質結構相比，很容易呈現出來。我們選擇最近4年來腹部常規超音波掃描發現腎臟含高回音病灶且電腦斷層為脂肪成份，經開刀病理證實或連續追跌6-24個月之21例，其中8例病理證明為血管肌肉脂肪瘤。1例病理證明為脂肪瘤。對其超音波與放射線檢查做一回顧分析。
並列摘要
Lipomatous tumors of the kidney are a rare mesenchymal neoplasm and angiomyolipoma is the most common tumor among them. Ultrasound and computed tomography have been proved to be valuable in the diagnosis. There are 21 renal lipomatous tumors, including 10 cases angiomyolipoma, 1 case lipoma, and 10 cases underterminated renal lipomatous tumors who had 6-24 months follow-up, collected in Tri-service General Hospital in recent 4 years. We retrospectly analysed the sonographic and computed tomographic finding. Seventeen cases presented with hyperechoic features and 4 cases are mixed in the ultrasonographic examination. All of the 21 renal lipomatous tumors revealed a fatcontaining mass in the computed tomographic images. We concluded that the ultrasonographic and computed tomographic images of renal lipomatous tumors are sufficiently characteristic to permit accurate radiologic diagnosis. Patient undergoing ultrasonography for evaluation of a renal mass should be examined carefully at varied gain setting and masses which are highly echogenic at low gain setting should be considered to be lipomatous tumors. However, these patients should be further evaluated by computed tomography. If low density, fat containing are demonstrated, then a confident diagnosis of renal lipomatous tumors is made and appropriated managenment planned. If the diagnosis remains doubtful, angiography should be followed and it might contribute diagnostically important information prior to surgery, especially for differentiation between malignant neoplasm.