无功能性肾上腺肿瘤的MRI评价

MRI diagnosis of the nonhyperfunctioning adrenal tumors

目的:探讨MRI对无功能性肾上腺肿瘤的诊断及鉴别诊断价值。方法:对94例经手术病理及临床证实的无功能性肾上腺肿瘤的MRI表现进行回顾性分析;66例患者平扫后作了Gd-DTPA增强扫描,22例患者(无功能腺瘤11例和非腺瘤3例)作了化学位移成像(CSI)序列扫描。结果:MRI对无功能性肾上腺肿瘤定位、定性(区分良、恶性肿瘤)及判断肿瘤组织学类型的准确性分别为97.9%、95.0%及91.0%。11例无功能腺瘤在MRI反相位(OP)图像上的信号强度(SI)都有明显下降,SI指数平均(51±16)%;非腺瘤的信号强度无明显下降。结论:MRI在对大部分无功能性肾上腺肿瘤的定位、定性及判断肿瘤组织学类型上具有优越性,CSI成像对鉴别腺瘤和非腺瘤有重要的价值。

Objective： To investigate the value of MRI in the diagnosis and differential diagnosis of nonfunctional adrenal tumors. Methods： MRI features of adrenal tumors verified with clinical and pathology were investigated retrospectively in 94 cases. The MR chemical shift imaging （CSI） was done in 25 cases （adenoma 11 cases and non-adenoma 14 cases）. Results： The accuracies of location, qualitatively diagnoses （differentiating benign tumor from malignant tumor） and tissue characterization of MRI were 97. 9%, 95.0% and 91.0% respectively. All of 11 nonfunctional adenomas exhibited the decrease in signal intensity （SI） on MR opposed-phase （OP） images, the average of SI index was （51±16）%, and non：adenomas showed no loss of signal intensity on OP images. Conclusion： MRI is useful in the location, qualitatively diagnoses and tissue characterization of nonfunctional adrenal tumors. CSI image can play an important role in distinguishing adenoma from non-adenoma.