肾上腺腺瘤MRI与组织病理学的对照研究

MR IMAGING OF ADRENAL ADENOMAS COMPARED WITH HISTOPATHOLOGY

目的 :探讨MRI化学位移成像对肾上腺腺瘤的定性诊断价值。方法 :对 2 3例肾上腺腺瘤和35例肾上腺其他占位性病变的患者行SE序列T1W、TSE序列T2 W和化学位移成像 (CSI)序列扫描。肿块直径 8～ 92mm。对手术标本进行病理对照研究和组织成分测定 ,从肿瘤的微观结构对腺瘤在磁共振化学位移成像上的表现进行了探讨和验证。结果 :腺瘤组有 2 0 / 2 3(87% )肿物 脾脏信号比 (ASR) <0 .6 0 ,而其他占位性病变ASR均大于 0 .73。MRCSI序列诊断肾上腺腺瘤的敏感性为 87% ,特异性为 10 0 %。结论 :MR化学位移成像对肾上腺腺瘤的定性诊断具有重要价值。

Objective:To assess the potential role of magnetic resonance (MR) imaging in diagnosis of adrenal masses. Methods:Fifty-eight adrenal masses (23 adenomas and 35 nonadenomas) in 55 patients were evaluated with chemical shift MR imaging, T 1W and T 2W MR imaging. The relative change in the signal intensity ratio of the adrenal mass to liver, spleen and water model was assessed. Opposed-phase turbo field echo (TFE) images were compared with in-phase images. The MR CSI appearance of a variety of adrenal masses was compared with their histopathologic findings. Results:The masses with an ASR less than 0.60 accounted for 87% of all the adrenal adenomas, while the ASR of other masses was greater than 0.73. MR CSI had a sensitivity of 87% and specificity of 100% respectively for aiagnosis of adrenal adenoma. Conclusion:MRI is of great value in the diagnosis of adrenal adenoma.