肾上腺基质肿瘤的CT表现

CT Features of Adrenal Interstitial Tissue Neoplasms

目的 分析肾上腺毖质肿瘤的CT表现.方法 收集手术病理证实的21例肾上腺基质起源肿瘤,其中髓脂瘤11例,脂肪瘤2例,囊肿3例,神经鞘瘤2例,血管瘤1例,淋巴瘤2例,回顾其各自的CT表现.结果 肾上腺髓脂瘤以女性多见（81.8%）,右侧多发（81.8%）,CT上表现为脂肪密度肿块,其内可见条形或片状软组织影（7/11例）,多数元强化（10/11例）;脂舫瘤均见于男性,位于右侧（2/2例）,肿瘤内为均匀的脂肪密度,当肿瘤内脂肪发生粘液变性时,则可为软组织密度;囊肿均发生于左侧（3/3例）.病灶内为水样密度影;神经鞘瘤均位于右侧（2/2例）,表现为软组织密度肿块,其中1例可见囊变影,增强后实质成分中度或明显强化;血管瘤增强扫描动脉期边缘结节样强化,延迟期整瘤均匀强化;淋巴瘤单侧及双侧各1例.表现为肾上腺区巨大占位.境界不清.沿脂肪间隙侵及或包绕肾脏、血管等邻近结构.结论 肾上腺基质起源的肿瘤临床相对少见,但其CT表现多较具有特征性,一般不难作出正确诊断.

Objective To analyze the CT features of adrenal interstitial tissue neoplasms.Methods 21 cases of adrenal interstitial tissue neoplasms confirmed by pathology were analyzed retrospectively.ll cases were adrenal myelolipoma,3 cases were cyst,1 case was hemangioma and lipoma,neurilemoma, lymphoma were 2 cases,respectively.Results Adrenal myelolipoma revealed as fat density with or without soft-tissue density and 10 cases showed no enhancement in 11 cases.Lipoma showed as homogenously fat density（l/2 cases） but as softtissue density when mucinous degeneration happened（1/2 cases）.Cyst had water density.Neurilemoma displayed as soft-tissue density with cyst-like density in 1 case;Hemangioma demonstrated peryphery nodal enhancement during arterial phase and whole lesion enhancement in delay phase.Lymphoma revealed as huge soft-tissue tumor offending neighbouring areas such as renal and vascular, et al.Conclusion Athough adrenal interstitial tissue neoplasms were relatively rare,the CT manifestations were characteristic.It is easy to make a correct diagnosis.