外伤性急性肾上腺损伤CT诊断

CT diagnosis of acute traumatic adrenal injury

目的:探讨外伤性急性肾上腺损伤的CT表现。方法:对外伤性急性肾上腺损伤的20例患者进行CT平扫,其中加CT增强扫描12例,20例均于外伤后2～5h行CT检查;随访CT复查17例;对其CT表现作回顾性分析。结果:20例中右侧18例,左侧1例;双侧1例。3例肾上腺挫伤CT平扫表现为肾上腺肿胀、增粗、边缘凸起、密度不均;17例肾上腺血肿CT平扫呈梭形或卵圆形密度均匀增高或混杂密度。肾上腺周围脂肪囊内线条或斑片状密度增高影6例,同侧膈脚增厚2例。增强12例中,挫伤2例增强显示肾上腺增粗,均匀强化1例,不均匀强化1例。血肿10例增强显示病灶边缘呈环状强化5例,呈线状强化3例,病灶无明显强化2例。17例随访复查CT显示血肿范围缩小,密度减低,CT值较急性期减低10～20HU。结论:外伤性急性肾上腺损伤CT表具有特征性,增强扫描及CT随访有助于诊断。

Objective:To explore the CT findings and differential diagnosis of adrenal gland injury.Methods:A total of 20 cases with adrenal gland injury were performed CT scanning;17 cases had been followed up by CT scanning after reatment.Results:Of all,19 cases were unilateral adrenal gland injury(18 in the right and 1 in the left),and 1 case had bilateral injury.3 cases showed adrenal enlarge ment on plain CT scanning with irregular border and heterogeneous density.17 cases showed round or oval adrenal mass with homogeneous or heterogeneous density.6 cases were found accompanied hyperdensity stripes around kidney,2 cases showed thickened isolateral pillars of diaphragm.9 cases showed cir-cular enhancement and 3 cases showed homogeneous enhancement.The follow-up CT scanning showed almost normal shape in all the 17 cases.Conclusion:Adrenal injury possesses characteristic in CT mainifestations.Enhanced CT scanning with follow-up by CT scanning has great value in its diagnosis.