肾上腺损伤的CT诊断

CT diagnosis of adrenal gland trauma

目的探讨肾上腺损伤(AGT)的CT表现及其诊断价值。方法对经手术或CT随访证实的30例AGT患者的CT表现进行回顾性分析。结果30例AGT中,29例为单侧肾上腺损伤(右侧25例,左侧4例),1例为双侧肾上腺血肿。其中20例行CT增强扫描。30例AGT的主要CT表现:肾上腺血肿18例,表现为孤立的卵圆形肿块,平扫为高密度或混杂密度,动态增强三期扫描均未强化,肿块外周见弧形强化的肾上腺肢体。肾上腺肿胀7例,表现为肾上腺体积增大,密度增高。肾上腺弥漫性出血5例,肾上腺被血肿湮没而不显示。结论CT能准确显示AGT的多种创伤后改变,对AGT的诊断具有重要价值。

Objective To study the CT findings arid evaluation of diagnosis of adrenal gland trauma （AGT）. Methods The CT features of 30 cases with adrenal gland trauma comfirmed by operation or following- up of CT scanning. Results Among these patients, unilateral adrenal injury （25 right-sided and 4 left-sided）, enhancement scanning had been carried out in 20 cases. Main CT findings were as follows： （1） Adrenal hematomas appeared as discrete round or oval masses expanding the adrenal gland in 18 lesions. The lesions were hyperdense or of mixed density in plain scan and did not enhance in three-phase contrast-enhanced dynamic scan. The limb of adrenal gland perihematomas were enhanced significantly as curvilinear structures. （2） Mild to moderate uniform swelling of gland was shown in 7 cases. （3） Diffuse irregular hemorrhage obliterating the gland was shown in 5 cases, the adrenal body was embed by the hematoma. Conclusion CT scanning can accurately show many pathoanatmic changes of adrenal gland trauma （AGT）, and play a very important role for the diagnasis of adrenal gland trauma.