肾上腺转移瘤的CT诊断

CT diagnosis of adrenal metastases

目的探讨CT对肾上腺转移瘤的诊断价值。方法回顾性分析23例经手术病理证实的肾上腺转移瘤CT征象。结果23例肾上腺转移瘤中10例为双侧,右侧5例,左侧8例。瘤体大小在1.5cm×1.2cm～12.5cm×9.7cm。23例的33个肿块均为实质性肿块,26个肿块小于4cm,为类圆形或椭圆形,密度均匀,边界清楚,其中5例增强扫描肿块呈均匀强化;7个肿块大于4cm,呈不规则形或分叶状,密度不均匀,其内可见坏死、囊变,边缘模糊,其中2例增强扫描呈不均匀强化。结论结合临床病史,CT平扫与增强扫描能对大多数肾上腺转移瘤作出正确诊断。

Objective To discuss the value of CT scans for diagnosing the adrenal metastases. Methods CT findings of 23 patients with surgically and pathologically proved adrenal metastases were retrospectively analyzed. Results Among 23 cases, the locations of adrenal metastases included left lesions（n=8）, right lesions（n=5）, and bilateral lesions（n=10）. All 33 metastatic tumors of 23 patients ranged from 1.5 cm×1.2 cm to 12.5 cm×9.7 cm in size and appeared as solid masses in which 26 masses were smaller than 4.0 cm and appeared as round or oval shape with well-defined margin and homogeneous density on non-enhanced CT images but 5 patients whose metastatic masses were homogeneous enhancement after administration of contrast medium; other 7 metastatic masses were larger than 4.0 cm in diameter and appeared as irregular or lobulated with ill-defined margin and nonhomogeneous density associated with intratumoral necrotic and cystic changes on nonenhanced CT images,but 2 patients whose metastatic masses were nonhomogeneons enhancement. Conclusion Combined with case history, CT scans without and with contrast enhancement may make the correct diagnosis for most adrenal metastases.