肾上腺间质肿瘤的CT和MRI诊断价值分析

Value analysis of CT and MRI in diagnosis of adrenal stromal tumors

目的探讨对肾上腺间质肿瘤行电子计算机断层扫描(CT)和磁共振成像(MRI)诊断的价值。方法28例手术病理确诊为肾上腺间质肿瘤患者,均实施CT和MRI诊断。分析患者的病理诊断结果及影像学特征。结果28例患者中,8例为肾上腺髓质脂肪瘤患者,12例为肾上腺囊肿患者,2例为肾上腺脂肪瘤患者,1例为肾上腺畸胎瘤患者,1例为肾上腺淋巴管瘤患者,1例为肾上腺神经鞘瘤患者,3例为肾上腺转移瘤患者。肾上腺髓质脂肪瘤影像学表现为不均质肿块内部存在明显的脂肪组织信号或者密度大多数存在条索状或者片状软组织信号或密度影,实施增强扫描后,肿瘤中软组织部分发生不均匀强化情况;肾上腺脂肪瘤影像学表现为均质脂肪密度或者信号;肾上腺囊肿影像学表现为水样密度,囊壁较薄,可出现钙化情况,增强扫描后未出现强化症状;肾上腺神经鞘瘤CT显示为稍低密度影,密度欠均匀,边界不清晰,增强扫描后,肿瘤表现为渐进性增强,强化程度为轻中度,强化不均匀,行MRI T1WI和T2WI诊断信号呈不均匀状态,强化效果不佳;肾上腺淋巴瘤影像学表现为特殊囊性低密度影,其边缘十分清晰,增强扫描后其囊壁会发生轻度强化;肾上腺转移瘤影像学表现为不规则软组织密度肿块,其肿块较大,极易发生液化坏死情况,增强扫描后会发生不均匀强化情况;肾上腺畸胎瘤表现为不均匀密度肿块,MRI诊断显示多种混杂信号。结论对肾上腺间质肿瘤行CT和MRI诊断,肾上腺囊肿、肾上腺髓质脂肪瘤、脂肪瘤患者均有显著的影像特点,其软组织肿瘤因无显著特点,在临床诊断中需将组织学检查结果相结合,实施诊断。

Objective To discuss the value of computer tomography(CT)and magnetic resonance imaging(MRI)in diagnosis of adrenal stromal tumors.Methods A total of 28 patients diagnosed as adrenal stromal tumors by operation and pathology were all diagnosed by CT and MRI.The patient’s pathological diagnosis and imaging features was analyzed.Results Of the 28 patients,8 cases were adrenal myelolipoma,12 cases were adrenal cyst,2 cases were adrenal lipoma,1 case was adrenal teratoma,1 case was adrenal lymphangioma,1 case was adrenal neurilemmoma,and 3 cases were adrenal metastases.The image features of adrenal myelolipoma was that there was obvious adipose tissue signal or density in the heterogeneous mass,most of which had strip-like or flaky soft tissue signal or density shadow;after the enhancement scan,the soft tissue part of the tumor had uneven enhancement.The image features of adrenal lipoma was homogeneous fat density or signal.The image features of adrenal cyst was watery density and a thinner cyst wall,calcification may occur,and no enhancement symptoms after enhanced scanning.The CT image of adrenal neurilemmoma were slightly lowdensity shadows,lack of uniform density,and unclear borders;after enhanced scanning,the tumor appears to be progressively enhanced,with mild to moderate enhancement,and uneven enhancement;the diagnostic signals of MRI T1WI and T2WI showed uneven state,poor strengthening effect.The image features of adrenal lymphangioma was a special cystic low-density shadow,with very clear edges,and mild enhancement of the cyst wall will occur after enhanced scanning.The image features of adrenal metastases was an irregular soft tissue density mass,which was large and prone to liquefaction and necrosis,and uneven enhancement would occur after enhanced scanning.Adrenal teratoma showed uneven density,and MRI diagnosis showed a variety of mixed signals.Conclusion CT and MRI diagnosis of adrenal stromal tumors,all adrenal cyst,adrenal myelolipoma,lipoma patients have significant imaging characteristics.But the soft tissue tumors have no significant characteristics,so it is necessary to combine the results of histological examination to carry out diagnosis in clinical diagnosis.