儿童肾上腺肿瘤的CT诊断（附八例报告）

CT Diagnosis of Adrenal Tumour in Children(A Report of Eight Cases)

作者报告了８例经手术后病理证实的儿童肾上腺肿瘤。其中肾上腺神经母细胞瘤６例，肾上腺皮质癌２例。作者对它们进行了ＣＴ和临床分析。肾上腺神经母细胞瘤的ＣＴ表现：形态规则２例；形态不规则肿块包绕后腹膜大血管４例；其中有５例存在肿瘤内钙化。其重要的临床表现为ＶＭＡ（３－甲氧－４－羟苦杏仁酸）升高。肾上腺皮质癌的ＣＴ表现：肿块大于４ｃｍ，形态规则，有包膜，密度不均。其临床表现为内分泌异常：柯兴综合征１例，男性化１例。作者认为，根据其ＣＴ特点，结合临床表现及有关的生化指标，能对儿童肾上腺肿瘤作出诊断。作者还讨论了儿童肾上腺肿瘤与肝、肾、后腹膜肿瘤的鉴别诊断及ＣＴ的临床应用价值。

This atricle reported eight cases of pediatric adrenal tumor comfirmed by operation and pathology. Among them. six were adrenal neuroblastoma and the other two primary adrenocorti-cal carcinoma.The CT appearances of the adrenal neuroblastoma were:two with regular shape. four were irregular with encasement of retroperitioneal vessels. Five of the six adrenal neuroblastomas had calcifications. The most important clinical features of adrenal neuroblastoma was increase of vanillylmandelic acid(VMA). The CT features of adrenocortical carcinoma were:regular shape. capsulated and heterogeneously dense. and the size of mass was over 4 cm. The main clinical mani-festations was disorder of internal secretion:one with Cushing syndrome. the other presented viriliz-ing disorder.The authors considered that with the help of CT characteristics. clinical manifestations and related biochemical data.an accurate diagnosis could be established.Differential diagnosis be-tween pediatric adrenal tumour and hepatic tumor. renal tumour and retroperitoneal tumour as well as evaluation of CT were discussed.