肾上腺静脉采血在嗜铬细胞瘤定性和定位诊断中的价值

The clinical value of adrenal venous sampling in the qualitative and topical diagnosis of pheochromocytoma(report of 4 cases)

目的:探讨肾上腺静脉采血(AVS)在嗜铬细胞瘤定性和定位诊断中的临床价值。方法:回顾性分析2020年10月至2021年9月广西医科大学第一附属医院确诊为嗜铬细胞瘤并行AVS的4例患者的临床资料,结合文献复习总结AVS对嗜铬细胞瘤定性和定位诊断的意义。结果:肾上腺CT平扫+增强+三维重建提示左侧肾上腺肿瘤3例,双侧1例。血儿茶酚胺六项有3例轻度升高,1例明显升高且合并皮质醇相关激素升高。AVS结果提示4例均为嗜铬细胞瘤,其中1例合并皮质醇增多症;3例肾上腺肿瘤优势侧在左侧,1例在右侧。4例患者均行腹腔镜下肾上腺肿瘤切除术(经腹腔3例,经后腹腔1例),术后病理均为嗜铬细胞瘤,其中1例肿瘤累及肾上腺皮质全层。结论:AVS可以作为嗜铬细胞瘤定性和定位诊断的一种有效的辅助手段。

Objective:To investigate the clinical value of adrenal venous sampling(AVS)in the qualitative and localized diagnosis of pheochromocytoma.Methods:The clinical data of four patients diagnosed with pheochromocytoma and underwent AVS at the First Affiliated Hospital of Guangxi Medical University from October 2020 to September 2021 were preoperatively analyzed.Results:CT of the adrenal glands suggested three cases of left adrenal tumors and one case of bilateral adrenal tumors.Blood catecholamines were mildly elevated in three cases and significantly elevated in one case in combination with elevated cortisol-related hormones.The results of AVS suggested all four cases were pheochromocytoma,one of which was combined with cortisolism;the dominant side of the adrenal tumor was on the left in three cases and on the right in one case.All four patients underwent laparoscopic adrenal tumor resection(transperitoneal in three cases and retroperitoneal in one case),and the postoperative pathology was pheochromocytoma in all four cases,with one case involving the entire adrenal cortex.Conclusion:AVS can be a useful adjunct to the qualitative and localized diagnosis of pheochromocytoma.