嗜铬细胞瘤CT动态增强扫描肿瘤血管显影征象的分析

Analysis of the signs by dynamic contrast-enhanced CT scanning of tumor blood vessels in pheochromocytoma

目的分析嗜铬细胞瘤CT动态增强扫描肿瘤血管显影征象的表现,提高对本病认识。方法复习经手术病理证实的13例嗜铬细胞瘤(研究组)临床资料及CT表现,并抽取17例其他肿瘤作对照(对照组)。结果 13例中5例(38%)可见肿瘤血管显影,对照组无一例出现,差异有统计学意义(P=0.005)。5例肿瘤直径4.5~6.5 cm,均可见坏死囊变但程度较轻,瘤实质有2例较明显强化,2例中度强化,1例轻度强化;显影的肿瘤血管形态各异,主要呈点、条及分枝状,粗细不均,数目不等,可出现在动脉期或静脉期。结论嗜铬细胞瘤CT动态增强扫描可显示肿瘤血管。血管显影征象更有利于反映肿瘤富血供的特点,其出现具有一定的敏感性,而且特异性更高,对于本病的诊断具有重要意义,因此血管显影征可作为诊断嗜铬细胞瘤的又一较特异的征象。

Objective Explore dynamic imaging by CT scanning for pheochromocytoma and to improve the understanding of this disease. Methods 13 cases with pheochromocutoma confirmed by surgery and pathology were in- cluded in the study group while 17 cases with other adrenal tumors were included in the control group. Clinical data and CT feature of these patients were ahalyzed and evaluated. Results Five of 13 cases （38%） had tumor vessel imaging. No case was shown in the control group. Significant statistical difference was found between two groups （p = 0.005）. The diameter of five tumors was 4.5 - 6.5cm, with slight necrosis and cystic lesions. Solid portion of the tumor was obviously enhanced in 2 cases, moderate enhanced in 2 cases, and shghtly enhanced in l case. Developed tumor vessels had different shapes： point, strip and branch with uneven thichness and size. They appeared in arterial or w;- nous phase. Conclusion Contrast dynamic CT scanning could reflect the blood supply and distribution characters. The appearence of tumor vessels in of great significance for the diagnosis of pheochromocytoma with cercain sensitici- ty and specificity. Thus vascular enhancement feature can be used as another specific sign for the diagnosis of pheochromocytoma.