多层螺旋CT对肾上腺嗜铬细胞瘤的诊断价值

Multiple-detector spiral CT imaging of adrenal pheochromocytoma

目的探讨肾上腺嗜铬细胞瘤的多层螺旋CT表现,提高CT诊断准确性。方法回顾性分析2008年1月—2011年2月经手术病理证实的并有完整病史资料的20例肾上腺嗜铬细胞瘤的CT表现特点。结果本组20例肾上腺嗜铬细胞瘤,1例为双侧,其余均为单发,共有21个病灶。单发病灶19个（右侧10个,左侧9个）,多发2个（双侧各1个）。呈圆形或类圆形17个,边缘分叶形3个,哑铃状1个。包膜完整18个,不完整3个。直径2.0~3.5 cm者6个,直径3.5~5.0 cm者7个,直径5.0~11.8 cm者8个。肾上腺嗜铬细胞瘤平扫表现为低等混杂密度或密度均匀的肿块,3个病灶中心部伴有钙化,呈颗粒状或边缘局限性的环形钙化。所有病例实性部分于动、静脉期呈明显强化,CT值较平扫增加40~80 HU,结论多层螺旋CT可显示肾上腺区较大肿块伴明显不均匀强化,结合临床资料,可提示嗜铬细胞瘤的诊断。

Objective To evaluate the multiple-detector spiral CT imaging of adrenal pheochromocytoma and improve CT diagnostic accuracy.Methods Pathologically confirmed by surgery and a complete medical history data of 20 cases of adrenal pheochromocytoma in CT performance characteristics were retrospectively analyzed.Results Of the 20 cases of adrenal pheochromocytoma,1 case was bilateral,the rest were single,there were a total of 21 lesions.Single lesion were in 19 cases,10 in right,9 in left.The diameter of was 2.0~11.8 cm,the average was 7.1 cm,diameter ≤3.5 cm in 6 cases,3.5-5.0 cm in diameter in 7 cases,diameter ≥5.0 cm in 8 cases.Adrenal pheochromocytoma scan showed homogeneous low density,mixed density or mass in the center of three cases of lesions with calcification,granular or the edge of the limitations of the ring calcification.Solid part of all cases in the arterial and venous phase was significantly enhanced,CT scan increase 40~80 HU than plain scan.Conclusion The adrenal gland is significantly larger mass with heterogeneous enhancement,combined with clinical data,can suggest the diagnosis of pheochromocytoma.