嗜铬细胞瘤的MSCT诊断

MSCT diagnosis of the pheochromocytoma

目的探讨MSCT对肾上腺嗜铬细胞瘤(pheochromocytoma,PHEO)与腹主动脉旁PHEO的诊断价值。方法回顾性分析27例PHEO患者的临床及CT资料,所有病例均经手术病理及免疫组织化学检查确诊。依据PHEO发病部位不同将27例PHEO分为肾上腺PHEO组(17例)和腹主动脉旁PHEO组(10例)两组。结果肾上腺PHEO与腹主动脉旁PHEO的CT平扫及增强的表现基本一致,无明显差异性(P>0.05)。平扫瘤体较大,呈圆形或类圆形软组织密度肿块影,肿块密度不均21例(77.78%),均匀6例,瘤体包膜完整、边界清楚。增强动脉期瘤体实质部分迅速、明显强化;静脉期强化有减退19例(70.37%),8例(29.63%)PHEO呈持续性强化特点,所有瘤体均可见一条或多条动脉血管供血。结论肾上腺PHEO与腹主动脉旁PHEO的CT表现不具差异性,嗜铬细胞瘤CT表现较具特征性,结合CT增强扫描术前多可作出定位、定性诊断。

Objective To summarize CT findings of pheochromocytoma （PHEO） in adrenal and beside abdominal aorta, and to probe the diagnostic value of MSCT in PHEO. Methods We retrospectively analyzed clinical and CT data in 27 pa- tients with PHEO, which were allmade a definite diagnosis with operation pathology and immunohistochemistry. Accord- ing to different pathogenesy places, 27 PHEO patients were divided into PHEO group in adrenal （17） and PHEO group besides abdominal aorta （10）, CT findings of lumps in 2 groups were summed up and briefly analyzed respectively. Results Findings of plain and enhancement CT scan were concord on the whole between PHEO in adrenal and PHEO besides ab- dominal aorta. There were no obvious differences （ P 〈0.05）. On the plain scan, the body of the tumor often was bigger and showed round and similar round lump shadow of soft tissue density, majority lump＇s densities were inequable （77.78G, 21/27）, the envelope of body of the tumor was complete and had clear border; essence part of body of the tumor in arterial phase on enhancement was reinforced quickly and obviously, enhancement became decreased on venous phase （70.37, 19/27）, part PHEO showed the feature of persistent reinforcement （29.63%, 8/27）; There were one or more than one arterial blood vessel to supply blood in all body of the tumor. Conclusion CT finding has no difference be- tween PHEO in adrenal and PHEO besides abdominal aorta. CT findings of PHECO has charaoteristics. Localization and qualitative diagnosis can be made by CT enhancement scan.