多层螺旋CT对双侧肾上腺疾病的诊断价值

Diagnostic Value of Multiple-detector Row CT in the Bilateral Adrenal Glands Diseases

目的探讨多层螺旋CT对双侧肾上腺疾病的临床诊断价值。资料与方法 34例双侧肾上腺疾病患者均行多层螺旋CT平扫,其中27例加行双期增强扫描,并行冠状面三维多平面重组(MPR)观察其影像学特征。结果 34例双侧肾上腺病变中,转移瘤20例,淋巴瘤4例,腺瘤3例,结核3例,嗜铬细胞瘤2例,皮质癌2例。转移瘤呈类圆形或不规则形,不均匀明显强化。淋巴瘤形态不规则,不均匀轻、中度强化。腺瘤边界清晰,平扫CT值<15 HU,中度强化。结核显示肾上腺弥漫性肿大、结核性肉芽肿形成及弥漫性钙化。嗜铬细胞瘤边界清晰,实性部分明显强化。皮质癌肿块较大,密度不均,强化明显但不均匀,可累及周围组织。结论多层螺旋CT是双侧肾上腺病变的首选检查方法。

Objective To investigate the clinical value of Multiple-detector row CT in diagnosing the bilateral adrenal glands diseases.Materials and Methods All the 34 patients underwent plain CT examination.Among them,27 patients underwent contrast CT examination.Coronal MPR was observed after three dimensional reconstruction.The CT features of the bilateral adrenal glands lesions were analyzed.Results The lesions included metastatic tumor（n=20）,lymphoma（n=4）,adenoma（n=3）,tuberculosis（n=3）,pheochromocytoma（n=2）,adrenocortical carcinoma（n=2）.Metastatic tumor presented as round or irregular mass with heterogeneous marked enhancement.Lymphoma presented as irregular mass with heterogeneous mild or moderate enhancement.Adenoma had clear margin,the CT value was less than 15 HU and moderate enhanced after CT contrast.The adrenal glands with tuberculosis involved showed diffused enlargement,tuberculous granuloma and diffused calcifications.Pheochromocytoma had clear border,the solid part was obviously enhanced after CT contrast.Adrenocortical carcinoma showed heterogeneous marked enhancement.Conclusion CT scan is the first choice for the bilateral adrenal glands lesions diagnosis.