原发性肾上腺肿瘤的MRI评价

An Evaluation of MRI in the Diagnosis of Primary Adrenal Tumors

目的:探讨MRI对原发性肾上腺肿瘤的诊断及鉴别诊断价值。方法:对96例经手术病理及临床证实的原发性肾上腺肿瘤的MRI表现进行回顾性分析,46例患者平扫后作了Gd-DTPA增强扫描,15例患者(腺瘤12例和非腺瘤3例)作了化学位移成像(CSI)序列扫描。结果:MRI对原发性肾上腺肿瘤的定位、定性(区分良、恶性肿瘤)及判断肿瘤组织学类型的准确度分别为98%、95%和91%。与同相位(IP)相比较,反相位(OP)图像上12例腺瘤的信号强度(SI)都有明显下降,SI指数平均为(52±18)%;3例非腺瘤OP图像上肿瘤的信号强度无明显下降。结论:结合临床表现和生化检查,MRI能诊断大部分原发性肾上腺肿瘤,对较大肿瘤的定位、定性及肿瘤组织学类型的判断有优越性。

Objective：To evaluate the clinical potentials of MRI in the diagnosis and differential diagnosis of primary adrenal tumors. Methods：MRI features of 96 clinically and pathologically verified cases of primary adrenal tumors were retrospectively studied. Gd-DTPA contrast enhancing MRI scan was performed in 46 cases, and chemical shift imaging （CSI） was undergone in 15 cases （including 12 cases of adenoma and 3 cases of non-adenoma）. Results：The MRI accuracy rates of tumor localization and nature diagnoses （differentiating benign from malignant tumors） as well as tissue characterization were 98%,95% and 91% respectively. All of the 12 adenomas exhibited a decrease of signal intensity （SI） on opposed phase （OP） images compared with that on phase （IP） images,with an average of SI index of 52±18% ,while there was no remarkable loss of signal intensity on OP images, Conclusion： In case that clinical and biochemical examination results were combined,MRI diagnosis and clinical evaluation of most of the primary adrenal tumors,including localization and nature of the tumor （differentiating benign from malignant tumors） as well as tissue characterization in larger tumors was capable.