肾上腺间质肿瘤的CT和MRI诊断

CT and MRI diagnosis of adrenal interstitial tomors

目的:探讨肾上腺间质肿瘤的CT和MRI影像表现。方法:对12例经手术病理证实的肾上腺间质肿瘤的CT和其中6例MRI资料进行回顾性分析。结果:12例肾上腺间质肿瘤包括骨髓脂肪瘤5例,囊肿2例,脂肪瘤、神经纤维瘤伴嗜铬细胞瘤、淋巴瘤、间皮瘤恶变、间叶组织来源恶性肿瘤各1例。骨髓脂肪瘤表现为不均质肿块内有显著的脂肪组织密度或信号;囊肿和脂肪瘤分别为均质的水和脂肪密度或信号;神经纤维瘤伴嗜铬细胞瘤为较低密度无强化肿块,MRI表现为不均匀长T1长T2信号;淋巴瘤、间皮瘤恶变及间叶组织来源恶性肿瘤为不规则软组织密度肿块。结论:骨髓脂肪瘤、囊肿、脂肪瘤表现有特征性,可明确诊断;其它表现为软组织肿块的肿瘤无特征性,诊断均需结合临床及组织学检查。

Objective： To study the imaging manifestations of CT and MRI in diagnosis of adrenal interstitial tumors. Methods： CT manifestations in 12 cases with confirmed adrenal interstitial tumors by surgery and pathology were analyzed retrospectively, there were 6 cases accepting MR examination. Results： This group included 5 cases of myelolipoma, 2 cases of cysts; and lipoma, neurofibroma accompanying pheochromocytoma, lymphoma, malignant transformation of mesothelioma, malignant mesenchymal tumor had Ⅰ case for each. CT/MR features of myelolipoma is marked fat density/signal intensity in the heterogenous masses. CT/MR features of cyst and lipoma are homogenous liquid and fat density/signal intensity, respectively. Neurofibroma accompanying pheochromocytoma reveals low density with on contrast enhancement on CT scans, and hypeintense on T1WI, hyperintense on T2WI. The CT/MR findings of lymphoma, malignant transformation of mesothelioma and malignant mesenchymal tumor are irregular masses. Conclusion： Myelolipoma, cyst and lipoma have certain characteristics of imaging features, and we can make a definite diagnosis. Diagnosis of other tumors are difficult only relying upon imaging, and should depend on clinic and histopathology.