CT靶扫描在肾上腺疾病诊断中的价值

The value of targeted CT scan in diagnosis of adrenal diseases

目的:评价CT薄层靶扫描在肾上腺疾病定位与定性诊断中的作用。方法:回顾性分析了55例病人56处经手术病理证实的肾上腺病变的CT影像资料,重点分析其形态、大小、密度及边缘情况。CT检查均为平扫与增强及薄层靶扫描。结果:肾上腺增生22例,CT表现主要为体积增大,其中髓质增生14例,肾上腺皮质增生8例,两者在形态及大小的CT表现无差别;肾上腺皮质增生中结节性增生4例,增强扫描后均为轻度强化;肾上腺皮质腺瘤14例,增强扫描后,轻度强化5例,中等强化7例,明显强化2例。34例肾上腺肿瘤性疾病的CT影像诊断符合率为77.14%。在定性诊断中,CT诊断与病理结果相一致有39例,误诊17例。结论:CT靶扫描在肾上腺疾病的定位及定性诊断中具有很高的价值。CT对大多数的肾上腺肿瘤性疾病诊断较为敏感;对于肾上腺髓质增生与皮质增生的鉴别,则没有明显的特异性;肾上腺皮质腺瘤可与皮质结节性增生鉴别。

Aim ： To evaluate targeted spiral CT scan diagnosis of adrenal diseases. Methods： Plain , enhanced and located enlargement targeted CT scanning were retrospectivly analyzed in 56 cases of pathologically proved adrenal diseases, put an emphasis on the analysis of shape, size, density and margin. Results： Twenty - two cases were adrenal hyperplasia, the enlargement volum were mainly character in CT imaging, the form were not changed. Twenty - two cases including fourteen cases of adrenal medullary hyperplasia; eight cases of adrenal cortex hyperplasia; there were no difference in the form and size. In the adrenal cortex hyperplasia, four cases were nodose hyperplasia, there were mild enhancement, fourteen cases were adrenal cortex adenoma, five of fourteen cases were mild enhancement, seven of 14 cases were middling enhancement,two of fourteen cases were obviously enhancement. About 77.14% CT diagnosis coineided with pathology in the 34 cases of adrenal tumor. Gonclusion： CT diagnosis is sensitive to a majority of adrenal tumor, CT diagnosis is not significantly specific to differentiate adrenal medullary hyperplasia and adrenal cortex hyperplasia. But it may differentiate adrenal cortex adenoma and adrenal cortex nodose hyperplasia on the size and reinforcement degree.