肾上腺神经鞘瘤的CT表现与肾上腺乏脂性皮质腺瘤对比分析

To Analyze the CT Findings of Adrenal Schwannoma in Comparison with Lipid-Poor Adrenocortical Adenoma

目的探讨肾上腺神经鞘瘤的临床特点、CT表现与肾上腺乏脂性皮质腺瘤的差异,提高对肾上腺神经鞘瘤的诊断水平。方法回顾性分析经手术病理证实的14例肾上腺神经鞘瘤和51例肾上腺乏脂性皮质腺瘤患者的CT表现,包括肿瘤部位、形态、大小、密度、边缘、钙化、囊变及强化方式等特点。结果高血压病史或血压升高症状,神经鞘瘤较乏脂腺瘤更少见(P=0.001)。病灶最长径神经鞘瘤普遍大于乏脂腺瘤(P<0.001),而且神经鞘瘤最长径多≥5 cm(P<0.001)。平扫肾上腺神经鞘瘤密度与乏脂腺瘤相比更加不均匀(P=0.028),且平扫CT值神经鞘瘤高于乏脂腺瘤(P<0.001),而动、静脉期神经鞘瘤强化值均低于乏脂腺瘤(P均<0.001)。神经鞘瘤强化程度较乏脂腺瘤低(P=0.008),而神经鞘瘤囊变较乏脂腺瘤更常见(P<0.001)。结论肾上腺神经鞘瘤的CT表现有一定的特征性,与乏脂腺瘤有差异。

Objective Analyzing the differences of clinical features and CT findings between adrenal schwannoma and lipid-poor adrenocortical adenoma（ LPACA） so as to improve the diagnosis of adrenal schwannoma. Methods The CT findings of 14 patients with adrenal schwannoma and 51 patients with LPACA proved by operation and pathology were retrospectively analyzed. To analyze the number,size,location,shape,density,edge,cystic degeneration,calcification and enhancement of tumors. Results Adrenal schwannoma is less associated with hypertension than LPACA（ P = 0. 001）.The longest diameter of adrenal schwannoma is generally greater than that of LPACA（ P〈0. 001）. Typically the longest diameter of adrenal schwannoma is more than 5 cm（ P〈0. 001）. On enhanced CT,the density of adrenal schwannoma is more uneven compared to LPACA（ P = 0. 028）,and the average CT value of adrenal schwannoma is higher than that of LPACA（ P〈0. 001）. However,the CT values of adrenal schwannoma are lower than LPACA in the arterial and venous phase（ P〈0. 001）. The enhancement of adrenal schwannoma is lower than that of LPACA（ P = 0. 008）. Cystic degeneration in the adrenal schwannoma is more common compared to LPACA（ P〈0. 001）. Conclusion Adrenal schwannoma has certain characteristic CT features,and there are significant differences from LPACA.