肾上腺肿瘤影像学检查的临床应用价值(附102例分析)

Evaluation of the Diagnostic Imaging for Adrenal Tumor: An Analysis of 1O2 Cases

目的：评价各种影像学检查方法诊断肾上腺肿瘤的临床价值，为临床医师合理选择和设计检查程序提供参考。材料与方法：以手术病理为依据，用比较影像学的方法，对各种影像学检查方法的定位、定性诊断正确率对比分析。结果：102例肾上腺肿瘤中良性肿瘤84例（内含囊性占位10例），恶性肿瘤18例。IVP、BUS、CT、CDFI、MRI的术前定位诊断正确率分别为46．3％、91．6％、96.9％、94．1％、92.9％，定性诊断正确率分别为13.4％、83.2％（鉴别囊、实性）、69.4％、64.7％、78.6％；综合影像组则高达100％及84．3％。结论：IVP定位、定性诊断正确率低；BUS对囊、实性的识别力高；IVP＋BUS可作为肾上腺肿瘤的筛选手段；CT、CDFI、MRI对肾上腺肿瘤的定位诊断正确率高，定性诊断正确率相近，对鉴别良恶性有一定价值。综合影像检查可发挥多种检查的互补作用，明显提高肾上腺肿瘤的诊断正确率。

Objective: To provide clinicians with diagnositc straegy and technique selection for adrenal tumor through evaluating vdrious imaging studies. Materials and Methods : The accuracy of localizing and qualitative dignosis was analyzed by companng vtrious imaging examinations withe pathelodcal findiop after surgery. Results:Of 102 cases with adrinal tumors, 84 were benign (including 10 cynic space-occupying lesions) and 18 malignant. The Pre-opration lesion-localizing accauarcy with IVP, BUS, CT, and and MRI was 46.3%, 91 .6%, 96. 9%, 94. 1 % and 92. 9%,respectively. The qualitative accarecy with the same modalities as above was 13. 4%, 83. 2 % (differentiation cystic with solid), 69. 4%, 64. 7%,and 78. 6%, respectively. For the group, in which the diagnosis was made by combining different imaging examinations, the accuracy of localizing and qualitative diagnosis was 100% and 84. 3%, respeedvely. Conclusion: IVP carries be accuracy in both localizing and qualitative dignosis, while BUS is powerful in diffrentiating cystic with soid lesions. IVP coupled with BUS can be used as a screening mehod. CT CDFI and MRI are very accurate in loralizing diagnosis, and have some value in differentiating benign with malignant. Combination of various examinations can give play to the advantages of diffeent modalities, and, thus, greatiy increase the diagnositc accuracy for adrenal tumor.