肾上腺肿瘤的CT、MRI诊断

CT and MRI diagnosis of adrenal tumors

目的探讨和比较CT、MRI对肾上腺肿瘤的诊断及鉴别诊断价值。方法回顾性分析204例经手术病理及临床证实的肾上腺肿瘤的CT、MRI表现。结果CT、MRI对肾上腺肿瘤定位、定性(区分良、恶性肿瘤)及判断肿瘤组织学类型的准确性分别为94.02%、91.85%、89.13%和98.15%、95.15%、90.74%。CT像素矩阵图上,25例(75.76%)肾上腺腺瘤内有轻度负CT值区域,非腺瘤无此征象。13例腺瘤在MRI反相位(OP)图像上的信号强度(SI)都有明显下降,SI指数平均(52.65±18.01)%;非腺瘤的信号强度无明显下降。结论结合临床表现和生化检查,CT、MRI能诊断大部分肾上腺肿瘤,两者的诊断价值相似,MRI对较大肿瘤的定位、定性及判断肿瘤组织学类型有优越性。

Objective To investigate and compare the value of CT and MRI in the diagnosis and differential diagnosis of adrenal tumors. Methods CT and MRI features of adrenal tumors verified with clinical and pathology were investigated retrospectively in 204 cases. Results The accuracies of location, qualitatively diagnoses (differentiating benign tumor from malignant tumor) and tissue characterization of CT and MRI were 94.02%, 91.85%, 89.13% and 98.15%, 95.15%, 90.74% respectively. On CT pixel mapping, 75.76% (25/33) of adenomas exhibited area of slightly negative CT attenuation values, none of non-adenomas showed this sign. All of 13 adenomas exhibited the decrease in signal intensity (SI) on MR opposed-phase (OP) images, the average of SI index was (52.65±18.01)%, and non-adenomas showed no loss of signal intensity on OP images. Conclusion Combined with clinical and biochemical examination, CT and MRI have the similar diagnostic efficacy for adrenal tumors, and could diagnose most of the tumors. MRI is useful in the location, qualitatively diagnoses (differentiating benign tumor from malignant tumor) and tissue characterization of larger tumors.