肾上腺皮质腺瘤与增生的MSCT诊断及鉴别诊断

MSCT diagnosis and differential diagnosis of adrenocortical hyperplasia and adenoma

目的探讨16层螺旋CT多期增强扫描在肾上腺皮质腺瘤及皮质增生中的诊断以及误诊原因分析。方法对本院已病理证实的肾上腺皮质腺瘤或皮质增生并行多期增强扫描的36例患者进行回顾性分析,均给予动脉期、门脉期、平衡期增强螺旋扫描。结果 36例手术患者中肾上腺皮质腺瘤27例(75%),皮质增生9例(25%),其中皮质腺瘤1例(1/27)CT误诊为髓脂瘤,1例(1/27)误诊为嗜铬细胞瘤,皮质增生3例(3/9)误诊为皮质腺瘤,1例(1/9)误诊为囊肿。结论 MSCT多期增强扫描薄层(2 mm)重建技术结合临床及实验室检查,能明显提高肾上腺皮质腺瘤及皮质增生的诊断率。

Objective To study 16SCT multi-phase enhanced scan＇s diagnosis and error reason diagnostic analgsis of adrenocortical hyperplasia and adenoma. Methods Thirty-six cases adrenocortical hyperplasia or adenoma from this hospital which confirmed by pathology were retrospectively analyzed. All the patients underwent CT scan （plain, artery time, portal time, balanced time）. Results In 36 cases, 27 （75%） cases of adrenal adenoma, 9 （25%） cases of adrenocortial hyperplasia were diagnosed. Among them 1 case of adrenal adenoma misdiagnosed myelolipoma, 1 case misdiagnosed pheochromocy- toma, 3 cases of adrenocortical hyperplasia misdiagnosed adenoma, 1 case misdiagnosed hematoma. Conclusion MSCT multi-phase enhanced scan and thin-layer （2 mm） reconstruction joint with clinical and laboratory examination significantly improves the diagnostic rate in diagnosing adrenocortical hyperplasia and adenoma.