肾上腺肿瘤的CT诊断价值

CT diagnosis of adrenal tumor

目的探讨CT对肾上腺肿瘤的诊断价值。方法回顾性分析有完整CT资料并经手术病理证实的肾上腺肿瘤49例，分析其大小、边缘、形态、密度及强化特征。结果32例中，皮质腺瘤11例，肿瘤直径为1．0～4、0cm，有包膜，密度均匀但较低，强化较轻。皮质腺癌3例，表现为不规则、分叶状、密度不均匀、环状强化的肿块。嗜铬细胞瘤8例，单侧，良性，瘤体大，平扫不均匀，实质强化明显，低密度区无强化。肾上腺囊肿2例，表现为边缘光滑、均质水样的囊性占位，增强无明显强化；髓质脂肪瘤2例，低密度的脂肪密度区是其特征性CT表现。转移瘤5例，多呈类圆形或不规则形肿块，密度均匀或不均匀，强化较明显。畸胎瘤1例，CT可见脂肪密度和钙化。结论CT对肾上腺肿瘤的检出率高，在定性诊断及鉴别诊断上有重要价值。

Objective To study the CT diagnostic value of adrenal tumor. Methods CT findings in 32 patients with pathologically proved adrenal tumors were retrospectively analyzed, focusing on the size, margin, morphology, density and enhancement pattern of the lesion, Results Of 32 cases, adenoma was seen 11 ,presenting as 1,0 - 4.0 cm encapsulated mass of low and homogeneous density with slight enhancement. Adenocarcinoma was seen in 3 cases and was manifested as irregular, lobulated mass of uneven density with ring - like enhancemen. Pheochromocytoma occurred in 8 cases and was marked by a mass of heterogeneous density on plain scans while showed marked enhancement on enhanced scans. The adrenal cyst was seen in 2 cases and had smooth margin and uniform watery mass. Myelolipoma was found in 2 cases and presented as low density area characteristic for fat contents. 5 cases had metastasis, all of which were from pulmonary cancers ,displaying as a round or irregular mass of homo - or hetero - geneou density with marded enhancement. One teratomas demonstrated fat density and calcifications. Conclusion The detecting rate of CT for adrenal tumor is high, so it has important reference value in qualitative diagnosis and differential diagnosis.