胸部CT体检中发现肾上腺意外瘤的分析

Adrenal Incidentaloma: Evaluation of Chest CT Screening

目的:回顾性分析胸部CT体检时发现的肾上腺意外瘤(肾上腺占位病变)的情况,提醒放射科技师和医师在胸部CT体检检查和诊断时避免遗漏肾上腺占位病变。方法:搜集2018年6月～8月我院体检中心胸部CT平扫8555例,均无相关内分泌异常表现。CT扫描仪为联影64层螺旋CT。肾上腺意外瘤由两位高年资(20年以上)副主任医生做出诊断。结果:胸部CT体检者中检出有肾上腺意外瘤者65例(单侧63例,双侧2例,其中单侧多发1例,共69个病灶),阳性检出率0.76%。病灶大小1.9～54.2mm,平扫CT值-45.8～60.4HU。影像学表现为类圆形低密度结节者62个病灶,约占90%。结论:胸部CT体检检出的肾上腺意外瘤约0.76%,提醒放射科技师进行胸部CT体检时扫描范围应该包括肾上腺,放射科医生应该重视其诊断,避免漏诊。

Purpose: To evaluate the diagnostic Performance of 65 cases of adrenal incidentaloma(AI retrospectively from 8555 non-contrast chest CT exams, and advise the radiologist and radiographers not to leave out adrenal lesions in chest CT examinations. Methods: From June to August in 2018, 65 cases of AI were found in 8555 cases of chest CT scans in our hospital, none of which was with the reported relevant endocrine abnormalities. The CT scanner was a 64-slice spiral CT(United Imaging, Shanghai). The AI was diagnosed by two senior radiologists(over20 years’ experience). Results: Sixty-five cases of AI(63 unilateral, 2 bilateral, including 1 unilateral with multiple lesions, 69 lesions totally) indicated that the prevalence of AI in chest CT was 0.76%, with the size 1.9-54.2 mm, their CT values ranged from-45.8 to 60.4 HU, and the imaging features of lesions were mostly characterized by round, lowdensity nodules. Conclusion: The detect rate of AI by the CT physical examination is about 0.76%. The radiologists and should pay attention to the area of the adrenal gland when the chest CT examination is performed.