肾上腺肿瘤的影像学诊断与临床治疗(附117例报告)

Diagnostic imaging procedures for adrenal tumors and the clinical treatment (report of 117 cases)

目的 总结肾上腺肿瘤的影像学诊断及外科治疗经验。 方法 应用比较影像学方法 ,对 117例患者的各种影像学检查方法的定位、定性诊断正确率及治疗结果进行分析。 结果 B超、CT、MRI定位准确率分别为 84.6 %、90 .6 %、98.1% ,术前定性准确率为 39.2 %、6 9.6 %、79.6 %。综合影像检查定位、定性准确率 10 0 .0 %及 87.5 %。手术切除 10 7例 ,其中巨大肿瘤 (体积 >10cm×5cm× 4cm) 30例。 9例肾上腺转移癌采取超声引导下穿刺硬化或介入性治疗。 1例未手术。 结论 肾上腺肿瘤影像学检查B超可作为筛选手段 ,CT、MRI定位准确率高 ,定性准确率MRI略高于CT。综合影像学检查可发挥互补作用。正确的手术切口选择是手术成功的要素之一。围手术期充分准备是减少并发症的保证。

Objective To study and evaluate the diagnostic procedures and the treatment strategy of adrenal tumors. Methods The accurate rate of localization and qualitative diagnosis of various imaging procedures for 117 cases of adrenal tumors were analyzed and the treatment efficacy studied. Results The accurate localization rate of the tumors was 84.6% for B ultrasonography,90.6% for CT,98.1% for MRI and the accurate qualitative diagnosis rate 39.2%,69.6% and 79.6% respectively.107 of the 117 cases were surgically cured,of which 30 were considered as large tumors with a volume exceeding 10 cm×5 cm×4 cm,the largest being 20 cm×15 cm×10 cm.9 patients underwent intervention therapy and no surgical procedure has been undertaken in 1. Conclusions Imaging procedures are very helpful for the localization and qualitative diagnosis of adrenal tumors.B ultrasonography can be used as a screening procedure.CT and MRI are high in accurate localization rate.As to the accurate qualitative diagnosis rate MRI is a little higher than CT.Accurate surgical incision is of prime importance for a surgical success.Adequate perioperative preparation can minimize complications to occur.Laparoscopic ultrasonography should be on schedule whenever laparoscopic adrenalectomy is contemplated.