肾上腺囊性病变的影像学诊断和鉴别

Differential Diagnosis of Adrenal Cystic Lesions

目的分析肾上腺囊性病变的影像学表现,以提高其诊断准确性。资料与方法经手术病理证实的肾上腺囊性病变16例,术前14例经螺旋CT和多排螺旋CT平扫增强扫描。2例经MR检查。然后与手术病理对照,回顾性分析CT和MR表现。结果16例病理证实的肾上腺囊性病变中,肾上腺上皮性囊肿8例,陈旧出血形成假囊肿3例,嗜铬细胞瘤囊变3例,原发性肾上腺癌囊变2例。肾上腺上皮性囊肿和肿瘤坏死囊变CT多表现为低密度,出血为等密度或高密度;T1WI为低信号或高信号,T2WI为显著高信号或低信号。囊内壁光整11例,毛糙5例。囊外壁光整13例,不规则3例。囊壁钙化2例。增强扫描显示壁强化11例,不强化5例。结论肾上腺囊性病变特征不同,有助于明确诊断。

Objective To evaluate imaging features of adrenal cystic lesions. Methods Computed tomography （CT） was performed in 14 cases with adrenal cystic lesions confirmed by surgical pathology, and magnetic resonance imaging （MRI） was completed in 2 patients. CT and MRI findings were reviewed retrospectively correlated with surgical and pathological results. Results Endothelial cysts were identified in 8 cases, pseudocysts from old hemorrhage in 3 cases, cystic pheochromocytoma in 3 cases, and cystic carcinoma in 2 cases. Cysts and cystic degeneration of the tumor showed low attenuation on CT, and hypointense on T1 -weighted images and hyperintense on T2-weighted images. Hemorrhage appeared hyperdense or isodense on CT. Smooth inner wall was seen in 11 cases, irregular inner wall in 5 cases, smooth outer wall in 13cases, and irregular outer wall in 3 cases. Calcification in the wall was found in 2 cases. Enhancement of the wall was observed in 11 cases and no enhancement in 5 cases after contrast administration. Condusions Various adrenal cystic lesions showed different features contributing to the diagnosis.