肾上腺囊性占位的多排螺旋CT诊断和鉴别

Differential diagnosis of adrenal cystic disorders by MDCT

目的探讨肾上腺囊性占位的多排螺旋CT表现特点,以提高其诊断准确性。方法回顾性分析27例经手术病理证实的肾上腺囊性病变的多排螺旋CT表现。结果 27例经病理证实的肾上腺囊性病变中,肾上腺单纯囊肿6例,肾上腺出血、感染或自发性出血所致的假性囊肿4例,肾上腺囊性淋巴管瘤3例,肾上腺神经鞘瘤2例,肾上腺髓样脂肪瘤2例,嗜铬细胞瘤囊性变6例,原发性肾上腺癌囊性变2例,肾上腺腺瘤囊性变2例。多排CT上囊肿的形态密度、囊壁厚度、有无壁结节、局部强化的方式和血供的特点可以鉴别肿瘤性囊肿和非肿瘤性囊肿、良性肿瘤囊性变和恶性肿瘤囊性变。结论肾上腺囊性病变的多排螺旋CT特征不同,有助于明确诊断。

Objective To evaluate the clinical imaging features of Multi-detector Computed Tomography（MDCT） in adrenal cystic disorders.Methods All 27 patients were performed MDCT with adrenal cystic lesions confirmed by pathology.MDCT findings were reviewed retrospectively correlated with pathological results.Results Among all the adrenal cystic lesions,6 of them were identified endothelial cysts,pseudocysts from old hemorrhage or infection in 4 cases,cystic adrenal lyphangioma in 3 cases,2 of them confirmed as adrenal medullare lipoma,neurilemmoma in 2 patients,adrenal pheochromocytoma in 6 patients and adenoma in 2 cases.The MDCT characteristics in shape,density and thickness of cyst wall,cyst wall nodus,enhancement feature and blood supply can discriminate non-cancer cyst,benign neoplasm cyst and malignant neoplasm.Conclusions Various adrenal cystic disorders showed different features contributing to the diagnosis in MDCT.