肾上腺结核的MSCT诊断及临床价值

Clinical value of MSCT in the diagnosis of adrenal tuberculosis

目的:探讨肾上腺结核在MSCT薄层扫描上的影像学表现特点,判断病变的程度对临床治疗的价值。方法:回顾性分析经穿刺病理和治疗随访证实的10例肾上腺结核病例。行MSCT薄层平扫及增强扫描,分析病变的影像学表现特点。结果:10例患者中5例伴有肾上腺外其它部位的结核,其中肺结核3例,脾结核1例,肾结核1例。双侧肾上腺受累8例,单侧肾上腺受累2例,共18个病变。其中14个病变保持肾上腺轮廓呈多发结节状、三角形、类圆形,4个病变失去肾上腺轮廓呈类圆形肿块状。5个病变密度均匀,13个病变密度不均匀,其中8个病变中出现钙化。5个病变呈均匀性强化,13个病变呈不均匀性强化,其中9个病变呈周边环形强化。结论:MSCT薄层扫描能清晰的显示肾上腺结核的病变范围、程度及与周围组织器官的关系,对临床诊断和病变疗效的随访起着重要指导作用。

Objective：To evaluate the imaging features of adrenal tuberculosis on thin-slice scan of MSCT and to de- termine the clinical therapeutic value of the extent of lesions. Methods： Ten cases of adrenal tuberculosis confirmed by fine- needle aspiration,pathology and follow-up were retrospectively analyzed. Thin-slice plain scan and contrast-enhanced scan were carried out by MSCT and imaging features of lesions were analyzed. Results： Five of the ten patients sufferred from tu- berculosis in other parts except for adrenal tuberculosis, including pulmonary tuberculosis in three cases, splenic tuberculosis in one case and renal tuberculosis in one case. Bilateral adrenal tuberculosis occurred in 8 cases and unilateral adrenal tuber- culosis in 2 cases. There was a total of 18 lesions, of which 14 kept adrenal contours and showed multiple nodular, triangular and round shape and 4 fell short of adrenal contour and showed round masses. Five lesions showed homogeneous density and 13 showed heterogeneous density, of which 8 had calcification. Five lesions showed homogeneous enhancement and 13 le- sions showed inhomogeneous enhancement,of which 9 showed peripheral ring enhancement. Conclusion：Thin-slice scan of MSCT can clearly show extent of adrenal tuberculosis and relationship with surrounding tissues and organs. It plays an im- portant role in clinical diagnosis and follow-up of therapeutic effect.