肾上腺嗜铬细胞瘤的MSCT表现特点

MSCT findings of adrenal pheochromocytomas

目的分析肾上腺嗜铬细胞瘤的MSCT表现及其动态增强特征,以提高其诊断准确性。方法回顾性分析经手术病理证实的肾上腺嗜铬细胞瘤15例,术前经多排螺旋CT平扫、动脉期和门脉期扫描。仔细复习CT扫描结果和手术病理作对照分析。结果 15例肾上腺嗜铬细胞瘤中,位于左侧肾上腺6例,右侧肾上腺8例,双侧肾上腺1例。肿瘤直径1.5～9.0 cm,其中>5 cm的3个,<5 cm的13个。肿瘤实质成分平扫、动脉期和门脉期CT值分别为:30.2～49.5 HU(平均36.5 HU),62.6～155.6 HU(平均98.5 HU)和57.8～122.4 HU(平均78.6 HU),其中肿瘤囊变、坏死共13例,占81.3%(13/16)。结论肿块富血供、易囊变、坏死是肾上腺嗜铬细胞瘤的MSCT表现特点,对其准确诊断有重要的提示价值。

Objective To explore the dynamic multi-slice CT（MSCT） findings and characteristics of adrenal pheochromocytomas and to evaluate its clinical value. Methods Fifteen patients with adrenal pheochromocytomas confirmed by surgical pathology underwent spiral CT plain scanning and 2 phases dynamic enhancement scanning beforeoperation. The CT images were reviewed and analyzed retrospectively in comparison with surgical and pathological results. Results Six of 15 patients were located in the right adrenal gland, 8 in the left and 1 in the both. The diameter of the tumors was 1.5-9.0 cm with 3 cases 〉5 cm and 13 cases 〈5 cm. The CT value of the plain scans, AP phases and PVP phases was 30.2-49.5 HU （mean value,36.5 HU）, 62.6-155.6 HU （mean value, 98.5 HU ） and 57.8-122.4 HU （mean value, 78.6 HU）, respectively. Thirteen tumors（81.3%,13/16） had cystic change and necrosis. Conclusion Hypervascular, cystic change and necrosis seem to be suggestive of the diagnosis of adrenal pheochromocytomas.