肾上腺髓质脂肪瘤的超声诊断价值

Diagnostic value of ultrasonography for adrenal myelolipoma

目的探讨肾上腺髓质脂肪瘤的超声特点及其诊断价值。方法总结17例经手术与病理证实的肾上腺髓质脂肪瘤患者的超声表现及临床资料，分析其声像图特点及超声诊断的准确性。结果17例（18个病灶）肾上腺髓质脂肪瘤中，超声表现为均质型强回声11个，强回声区内分布低回声5个，囊实混合性回声1个，1个漏诊，彩色多普勒超声检查上述病灶内均未见明确血流信号。超声和增强CT诊断为肾上腺良性占位的敏感性均为94.1％（16/17），诊断为肾上腺髓质脂肪瘤的敏感性分别为23．5％（4/17）、82．4％（14/17），增强CT诊断肾上腺髓质脂肪瘤敏感性明显高于超声（P=0.0039）。结论超声可作为筛选肾上腺髓质脂肪瘤的首选检查和随访观察方法，而增强CT对肾上腺髓质脂肪瘤的定性诊断十分有价值。

Objective To evaluate the characteristics and diagnostic value of ultrasonography for adrenal myelolipoma. Methods The clinical and ultrasound data of 17 patients with adrenal myelolipoma were analyzed retrospectively. Results Among 17 patients, 18 myelolipomas were detected, 11 of which were in right adrenal gland, 5 in the left and one patient was bilateral. Internal echoes included： 11 lesions were homogeneous with high echo, 5 lesions showed low echo in the high echo area, 1 lesion showed a mixture of cystic and solid echo, 1 lesion missed diagnosis. No blood signal was not found in the lesions. Diagnostic sensitivity of benign tumor for adrenal gland by ultrasonography and CT both was 94.1% （16/17）,and diagnostic sensitivity of adrenal myelolipoma by ultrasonography and CT were 23.5% （4/17）, 82.4% （14/17）, respectively. CT was superior to ultrasonography in diagnosis of adrenal myelolipoma（ P = 0. 0039）. Conclusions Ultrasonography is a reliable and perhaps the ideal means of detection and follow-up for adrenal myelolipmal,and CT is of great value for diagnosis of adrenal myelolipoma.