64层螺旋CT诊断肾上腺囊性病变

64-slice Spiral CT in the Diagnosis of Adrenal Cystic Lesions

目的探讨肾上腺囊性病变的CT表现特点,提高其诊断准确性。资料与方法经手术病理证实31例的肾上腺囊性病变患者,术前均行64层螺旋CT平扫加增强扫描,层厚2.5mm,并行0.625mm薄层重建及多平面重组,分析肾上腺囊性病变的CT表现。结果 31例肾上腺囊性病变中,肾上腺上皮性囊肿5例,肾上腺淋巴管囊肿3例,肾上腺血肿4例,肾上腺化脓性炎性假囊肿1例,肾上腺皮质腺瘤囊性变4例,肾上腺嗜铬细胞瘤囊性变10例,肾上腺节细胞神经瘤2例,肾上腺神经鞘瘤囊性变1例,肾上腺转移瘤囊性变1例(原发肿瘤为肺癌)。64层螺旋CT上囊性病变的形态、密度、囊壁厚度、有无壁结节、强化特点可以鉴别肿瘤性和非肿瘤性囊肿、良性和恶性肿瘤囊性变。结论肾上腺囊性病变的64层螺旋CT特征不同,有助于明确诊断。

Purpose To evaluate the imaging features of adrenal cystic lesions, and improve the diagnostic accuracy. Materials and Methods 31 patients with pathology proven adrenal cystic lesions were examined with pre-contrast and contrast-enhanced 64-slice spiral CT before surgery. The slice thickness was 2.5 mm. Then thin slice reconstruction and multiple planar reconstruction were performed. CT findings were reviewed retrospectively to correlate with pathological results. Results Among 31 patients with adrenal cystic lesions, there were 5 endothelial cysts, 3 cystic adrenal lymphangioma, 4 pseudocysts from old hemorrhage, l pseudocyst from suppurative inflammation, 4 adenomas, 10 adrenal pheochromocytomas, 2 ganglioneummas, 1 adrenal medullary lipoma, and 1 adrenal metastasis from lung cancer. The 64-slice spiral CT characteristics in shape, density, thickness of cyst wall, cyst wall nodus, enhancement features could discriminate neoplasm cyst and non-neoplasm cyst, benign cyst and malignant cyst. Conclusion Various adrenal cystic lesions show different features contributing to the diagnosis in 64-slice spiral CT.