肾上腺血管瘤的CT及MRI的表现与病理对照研究

Findings of CT and MRI of Hemangioma in the Adrenal Gland with Pathologic Correlation

目的旨在提出肾上腺血管瘤的ＣＴ及ＭＲＩ的表现特点。方法回顾分析经手术病理证实肾上腺海绵状血管瘤６例。位于肾上腺５例，异位肾脏１例。ＣＴ扫描５例，ＭＲＩ扫描４例。结果肿瘤最大径５ｃｍ～１２ｃｍ；呈圆形或椭圆形，实性５例，囊性１例；全部有完整包膜；肿瘤边缘清楚锐利５例。ＣＴ表现：平扫３例，囊状１例，密度均匀或不均匀各１例。增强扫描４例中３例肿瘤边缘见高度强化的结节状及条状影，１例见对比剂向瘤体中部充盈。ＭＲＩ表现：Ｔ１ＷＩ肿瘤呈低信号团块。Ｔ２ＷＩ肿瘤信号明显不均匀，高低信号对比明显，边缘区有结节及条状高信号影，中部为不规则高信号区与低信号区混杂存在。动态增强扫描３例肿瘤边缘均见结节状及条状强化。异位于肾内病灶在ＣＴ及ＭＲＩ图像上与原发肾癌相似无法区别。结论在ＣＴ及ＭＲＩ增强图像中肿瘤边缘见结节状、条状明显强化影是血管瘤的特征。因此强调在肾上腺肿瘤诊断中增强扫描是非常必要的。ＭＲＩＴ２ＷＩ像显示肿瘤信号明显不均匀，高低信号对比明显及边缘见高信号结节或条状影与其它肿瘤不同。

Objective To search characterize findings of CT and MRI of hemangioma in the adrenal gland.Methods Six patients with cavernous hemangioma with pathologically proved were review retrospectively,5 cases arose from adrenal gland and 1 case from adrenal tissue in the right kidney.CT scans 5 cases and MRI 4 cases.Results Tumors were round or ovoid,solid 5 and cystic change 1,their size were 5cm～12cm with complete capsule and well defined contour in 5 cases.As seen on CT scans,one in each with cystic,heterogeneous or homogeneous desity on unenhanced CT scan;nodular and stripe higher density configuration at the periphery of masses in 3/4 cases and contrast uptake at center of mass in followed phases scan in one case on the enhancement CT scan.As seen on MRI scans,low signal masses with hetergeneous or homogeneous were nonspecific findings on T 1WI,the striking hetergeneous signal with nodular or strip high signal at periphery of the masses and mixed signs of low and high at center of the masses on T 2WI. The nodular and stripe sigh of contrast enhancement at the periphery of the masses were showed on the dynamic MRI in 3/3 cases.The mass in the kidney was showed resemble renal cancernoma.Conclusion The nodular and stripe findings with marked enhancement at the periphery of the masses is characterized feature of hemangioma on either enhancement CT or enhancement MRI.Enhancement CT or enhancement MRI scan would be needed and is very important for diagnosis of adrenal hemangioma.It is thought another characterized finding of hemangioma of adrenal gland that the signal of mass was marked hetergeneous with contrast evidently of low and high signal areas and high signal nodular and stripe at the periphery of mass on the MRI T 2WI. [