肾上腺结核致Addison病的MDCT表现

MDCT Findings of Addison Disease Caused by Adrenal Tuberculosis

目的:探讨肾上腺结核致Addison病的MDCT特征性表现。方法:回顾性分析17例经临床证实的肾上腺结核的MDCT形态学表现和强化方式。结果:17例患者均双侧肾上腺受累(100%),其中表现为肾上腺增大共25个(25/34,73.5%),表现为肾上腺萎缩9个(9/34,26.5%)。25个增大的肾上腺中,16个(16/25,64%)保持原有的轮廓,9个(9/25,36%)失去原有的轮廓而表现为肿块型,21个(21/25,84%)肾上腺呈周边环形强化,4个(4/25,16%)肾上腺呈不均匀强化。肾上腺病灶大小在1.48～6.82cm(平均为3.19±1.075cm)。钙化出现在23个(23/34,67.6%)肾上腺中。结论:MDCT能很好地显示肾上腺病灶的形态学改变和CT强化特点,同时结合临床表现和生化指标,可明显提高肾上腺结核诊断的准确性。

Purpose：To discuss the multi-detector-row computed tomography （MDCT） findings of Addison disease caused by adrenal tuberculosis.Methods：The un-enhanced and contrast-enhanced MDCT features of 17 patients with clinically confirmed Addison disease caused by adrenal tuberculosis were retrospectively assessed for the morphology and enhancement patterns. Results：The adrenal glands were involved bilaterally in all of the 17 cases （100%）. Enlargement appeared in 25 adrenal glands （25/34,73.5%）,and atrophy in 9 adrenal glands （9/34,26.5%）. Of the 25 enlarged adrenals,16 cases（16/25,64%） had preserved contours,and the other 9（9/25,36%） were mass-like.Twenty-one of the 25（84%） enlarged adrenals showed peripheral enhancement while the remaining 4（16%） demonstrated heterogeneous enhancement. The size of the adrenals lesion ranged from 1.48 to 6.82 cm （mean 3.19±1.075cm）. Calcification was revealed in 23 adrenals （23/34,67.6%）. Conclusion：MDCT can reveal the characteristic morphology and CT attenuation in the Addison disease caused by adrenal tuberculosis. Combined with its clinical presentation and biochemical findings,we can diagnose adrenal tuberculosis with high accuracy on MDCT.