肾上腺皮质癌的CT诊断及鉴别诊断

Adrenocortical carcinoma: value of CT diagnosis and differential diagnosis

目的:探讨肾上腺皮质癌的CT诊断及鉴别诊断价值。方法:回顾性分析经手术及病理证实的16例肾上腺皮质癌的CT表现。结果:16例皮质癌中,位于右侧肾上腺10例,左侧肾上腺6例。肿瘤直径5.2～13.4cm,平均9.2cm,病灶呈圆形或卵圆形5例、形态不规则11例,瘤体内坏死13例,边缘结节状强化3例,瘤体内钙化8例,周围脂肪间隙见条索状异常密度影6例,4例邻近脏器侵犯,1例发生肺部转移,1例发生门静脉癌栓。増强扫描可见瘤体实质成分不同程度强化及延迟扫描后进一步强化。结论:肾上腺区肿瘤的大小、形态、坏死、周围浸润及转移、强化方式对肾上腺皮质癌的诊断及鉴别诊断具有重要价值。

Objective：To discuss the value of CT diagnosis and differential diagnosis value in adrenocortical carcinoma.Methods：CT manifestations of 16 surgically and pathologically proved adrenocortical carcinoma were retrorespectively analyzed.Results：10 of 16 lesions were located in the right adrenal gland,6 in the left.The diameter of the tumors was 5.2~13.4cm,and the mean diameter was 9.2cm.The tumors were round or oval（n=5）,or irregular（n=11）;necrosis（n=13）,nodular enhancement（n=3）,calcification（n=8）,abnormal cords in fatty tissue around tumors（n=6）,invasion of adjacent structures（n=4）,lung metastatis（n=1）,portal vein tumor thrombus（n=1） could be found on CT imaging.Uneven enhancement could be seen in the solid part of the tumors and the enhancement was more obvious in the delay phase.Conculsion：The size,shape,necrosis,infiltration of adjacent structures and metastatic,mode of enhancement provide important information for the diagnosis and differential diagnosis of adrenocortical carcinoma.