肾上腺损伤的CT诊断

CT Diagnosis of Adrenal Gland Injury

目的:探讨肾上腺损伤的CT表现和鉴别诊断。方法:CT检查肾上腺损伤22例,其中平扫22例,增强扫描12例,随访CT 17例;MRI检查1例,B超检查12例。CT检查外伤后最短时间2 h,最长达7 d,平均19.8 h。回顾性分析其CT表现及影像特点。结果:22例肾上腺损伤,单侧21例(右侧15例,左侧6例),双侧1例。CT表现为平扫肾上腺增大6例,边缘凸起,密度不均;肾上腺肿块16例,呈圆形或卵圆形均匀增高或混杂密度。肾上腺周围脂肪囊内见密度增高线条状影及高密度模糊影15例。同侧膈脚增厚11例。增强扫描12例中,呈不均匀强化4例,环状强化8例。随访CT显示肾上腺形态基本正常,其中3例肾上腺区肿块吸收、消失。结论:CT检查对肾上腺损伤诊断及鉴别诊断具有重要意义。

To explore the CT findings and differential diagnosis of adrenal gland injury. Methods： A total of 22 eases with adrenal gland injury were performed CT scanning, one case was performed MRI, and 19, cases were performed B-mode ultrasonography; 17 cases has followed up by CT scanning after treatment. Results： Of all, 21 cases were unilateral adrenal gland injury （15 in the right and 6 in the left）, and one case had bilateral injury. Six cases showed adrenal enlargement on plain CT scanning with irregular border and heterogeneous density. Sixteen cases showed round or oval adrenal mass with homogeneous or heterogeneous density. Fifteen cases were found accompanied hyperdensity stripes around kidney, 11 cases showed thickened isolateral pillars of diaphragm, four cases showed homogeneous enhancement, and eight cases showed circular enhancement. The follow-up CT scanning showed almost normal shape in all the 17 eases, and the injury lesions disappeared completely in three cases. Conclusion. CT examination is of great value in adrenal injury diagnosis and differential diagnosis for adrenal gland injury.