肾上腺肿瘤的CT诊断与鉴别诊断

CT diagnosis and differential diagnosis of adrenal neoplasms

目的探讨不同病理类型的肾上腺肿瘤的CT表现,以提高诊断水平。方法对32例经手术病理证实的肾上腺肿瘤进行回顾性分析,在CT图像上,观察病变的位置、大小、形态、密度、边缘,测量病灶增强前后的CT值。结果醛固酮腺瘤9例,体积较小且密度低,增强后轻度增强;皮质醇腺瘤5例,瘤体较大,边界清,密度略低于正常肾上腺组织;无功腺瘤1例;结节增生5例,为等或稍低密度影,增强后强化较明显;嗜铬细胞瘤4例,体积较大,密度不均,可见多个囊变坏死区;皮质腺癌2例,肿块形态不规则,边缘模糊,密度不均匀,易发生大片坏死及点状钙化;转移瘤3例;神经纤维瘤、神经节瘤及髓性脂肪瘤各1例。结论CT表现与肾上腺肿瘤的病理基础有关,结合临床资料可提高肾上腺肿瘤的诊断真确率。

Objective To investigate the correlation between CT findings and pathological results of adrenal neoplasms so as to improve the accuracy of diagnosis. Methods CT manifestations of 32 cases with pathological diagnosis adrenal neoplasms were retrospectively analyzed. The location, size, shape, density and relationship with surrounding structure were evaluated on CT image. The attenuation values at unenhanced and enhanced CT of the tumor were also recorded. Results The 32 cases adrenal neoplasms included 9 cases with aldosterone-producing adenoma, 5 hydrocortisoneproducing adenomas, lnon-functional adenoma, 5 cortical hyperplasies, 4 pheochromocytomas, 2 adenocarcinomas, 3 metastases, 1 fibroneuroma, 1 ganglioneuroma and 1 myelolipomas. Conclusion The characteristics on CT images are associated with the pathological feature in adrenal neoplasms. With a combination of clinical date and CT findings, adrenal neoplasms can be be correctly diagnosed in most cases.