肾上腺节细胞神经瘤的CT诊断价值

CT diagnostic value of adrenal ganglioneuroma

目的分析肾上腺节细胞神经瘤的 CT 表现及其血液动力学特征,以提高其诊断准确性。方法回顾性分析经手术病理证实的肾上腺节细胞神经瘤7例,术前均经 CT 平扫及增强扫描,复习 CT 扫描结果并和手术病理作对照分析。结果 7例肾上腺节细胞神经瘤中,右侧6例,左侧1例。肿瘤直径3.7～7.5 cm,平均4.6 cm。肿瘤平扫 CT 值16.2～31.7 HU,平均24.3 HU;动脉期增强 CT 值20.9～36.6 HU,平均30.2 HU;门静脉期增强 CT 值27.4～45.5 HU,平均36.0 HU。所有肿瘤边界清楚,瘤体自身受压变形4例,形成伪足样尖角3例。5例肿瘤推移下腔静脉,其中,2例瘤体部分包绕下腔静脉,所有病例下腔静脉形态均正常。肾上腺节细胞神经瘤呈嵌入性生长,容易推移或包绕但不压迫邻近血管。结论肾上腺节细胞神经瘤动态增强呈进行性轻度延迟强化,但动脉期强化轻微,类似囊性肿瘤。CT 平扫和动态增强扫描对于此病的诊断有明显的价值。

Objective To explore the dynamic spiral CT findings of adrenal ganglioneuromas and to evaluate its clinical value. Methods All 7 cases patients with adrenal ganglioneuromas confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation. The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results. Results Six of 7 lesions were located in the right adrenal gland, 1 in the left. The diameter of the tumors was 3.7--7.5 cm,with a mean diameter of 4. 6 cm. The CT value of the plain scans, AP phases and PVP phases was 16. 2--31.7 HU（with a mean value of 24. 3 HU）, 20. 9-36. 6 HU（with a mean value of 30. 2 HU ）, and 27.4-45.5 HU （ with a mean value of 36. 0 HU ）, respectively. The masses were well defined and showed a tendency of wedging into the space between the adjacent organs and structures and encasing the large vessels such as Ⅳ, but didn＇t compress or occlude them. Conclusion The dynamic SCT features of adrenal ganglioneuromas were obvious, dynamic SCT scans could suggest the diagnose.