肾上腺节细胞神经瘤的多层螺旋CT诊断与临床分析

The MSCT diagnosis and clinical analysis for adrenal ganglioneuroma

目的对肾上腺节细胞神经瘤的多层螺旋CT(MSCT)诊断与临床特征进行分析。方法对我院2010—2012年收治的60例肾上腺无功能性肿瘤患者进行回顾性分析。其中肾上腺节细胞神经瘤患者18例,肾上腺无功能腺瘤患者24例,转移瘤8例,无功能嗜铬细胞瘤患者10例,共64个病灶。采用Lightspeed VCT 64层螺旋CT扫描仪对其病灶行平扫及随后30 s、70 s、3 min动态增强扫描,并将其影像学表现进行比较分析。结果①肾上腺节细胞瘤形态上大多表现为卵圆形,边界模糊,密度均匀,有明显的桃尖征,病变部位多以右侧为主,可又钙化的情况出现;②肾上腺节细胞神经瘤在同一扫描或时间点的CT平均值与其他各病变类型差异均有统计学意义(P<0.05),其中平扫时表现出密度高于无功能腺瘤,而低于嗜铬细胞瘤和转移瘤,而在增强扫描各时间点其密度则表现出明显低于其他各病变类型,差异均具有统计学意义(P<0.05)。结论临床上肾上腺节细胞神经瘤与其他各类型肾上腺无功能肿瘤相比,其MSCT表现在其病变形态、边界清晰度、肿瘤内钙化、发病部位与平扫CT平均值及增强扫描各时间点CT平均值均有明显的差异性,临床可根据其特点进行鉴别诊断,并对其手术治疗提供影像学依据。

Objective To analyze the MSCT diagnosis and clinical features of adrenal ganglioneuroma.Methods Sixty cases of patients with nonfunctional adrenal tumor who were treated in our hospital from 2010 to 2012,were retrospectively analyzed.In 60 cases of patients,there were 18 patients with adrenal ganglioneuroma,24 patients with adrenal non-functional adenomas,8 cases with metastatic tumors,and 10 patients with nonfunctional complextumor.Choosed 64 layers spiral CT scanner of Lightspeed VCT to line scan and dynamic enhanced scan of 30 s,70 s,3min on the focus,and compared the imaging findings.Results ①The morphology of adrenal ganglioneuromamostly characterized by ovoid,fuzzy boundaries,uniform density,obviously peach lip levy,more predominantly on the right side of the lesion site,and had calcification.②At the same average CT scan or same point scan,theadrenal ganglioneuromacompared with the other types of pathological changes were obvious difference（P〈0.05）,the plain scan showed that the density of adrenal ganglioneuromawas higher than non-functional adenoma,and lower than nonfunctional complextumor and metastatic tumors,but at various points of enhanced scan its density showed a significantly lower than other pathological types,the differences were statistically significant（P〈0.05）.Conclusion Clinicaladrenal ganglioneuroma compared with other various kinds of nonfunctioning adrenal tumors,the performance of MSCT in its pathological changes shape,boundary definition,calcification within the tumor,pathogenic site and the average value of plain scan and enhanced scan at various points all had obvious differences,and according the characteristics can take clinical differential diagnosis,and provide imaging basis for its surgical treatment.