自发性肾上腺血肿与肾上腺皮质腺瘤的CT鉴别诊断

Differential Diagnosis of Idiopathic Adrenal Hematomas and Adrenocortical Adenoma: CT Analysis

目的比较自发性肾上腺血肿(IAH)与肾上腺皮质腺瘤(ACA)的CT特点,提高IAH的诊断正确率。资料与方法回顾性分析经病理证实的7例IAH及12例ACA的CT表现。结果 7例IAH中,6例密度均匀,1例密度不均匀;12例ACA中,9例密度均匀,3例密度不均匀,两者差异无统计学意义(P>0.05)。ACA中2例出现钙化;IAH无一例钙化。CT平扫时IAH及ACA的平均CT值分别为(40.68±9.32)Hu、(17.05±20.38)Hu,差异有统计学意义(P<0.05);动脉期IAH及ACA的平均CT值分别为(43.65±8.81)Hu、(44.78±16.27)Hu,差异无统计学意义(P>0.05);门静脉期IAH及ACA的平均CT值分别为(46.15±6.87)Hu、(60.85±19.86)Hu,差异有统计学意义(P<0.05);IAH及ACA动脉期CT值增幅分别为(2.96±3.38)Hu、(27.73±9.83)Hu,差异有统计学意义(P<0.05)。门静脉期增幅分别为(5.47±4.97)Hu、(43.80±11.65)Hu,差异有统计学意义(P<0.05)。结论结合临床及增强扫描前后病变CT特征,对IAH与ACA的鉴别诊断有重要作用。

Purpose To compare CT features of idiopathic adrenal hematomas （IAH） and adrenocortical adenoma （ACA） for a better diagnosis of IAH. Materials and Methods A retrospective study was carried out on the CT findings of 7 patients with pathologically confirmed IAH and 12 patients with pathologically confirmed ACA. Results Seven IAH cases： 6 with homogenous density, 1 with heterogeneous density; 12 ACA cases： 9 with homogenous density, 3 with heterogeneous density （difference without statistic significance P〉0.05）. Two ACA cases had calcification whilst none 1AH cases showed calcification. Plain CT scans： average CT value of IAH was （40.68_＋9.32） Hu and that of ACA was （17.05 ＋20.38） Hu （difference with statistic significance P〈0.05）. During arterial phase the average CT value oflAH and ACA were （43.65±8.81） Hu and （44.78± 16.27） Hu. respectively （difference without statistic significance, P〉0.05）; during portal venous phase the average CT value of IAH and ACA were （46.15±6.87） Hu and （60.85± 19.86） ttu, respectively （difference with statistic significance P〈0.05）; the increased CT value of IAH and ACA were （2,96±3.38） Hu and （27.73±＋9.83） Hu, respectively during arterial phase （difference with statistic significance P〈0.05）; the increased CT value of IAH and ACA were （5.47±4.97） Hu and （43.8±11.65） Hu, respectively （difference with statistic significance P〈0.05）. Conclusion The findings of enhanced CT scan can be helpful to tile differential diagnosis of idiopathic adrenal hematolnas and adrenocortical adenoma..