动态增强MRI CT在肾上腺肿瘤中的诊断价值对比分析

Comparative Analysis of the Diagnostic Value of Dynamic Enhanced MRI and CT in Adrenal Tumors

目的:探讨动态增强MRI、CT对于肾上腺肿瘤的鉴别诊断价值。方法:选取我院2013年10月至2018年9月我院收治的肾上腺肿瘤患者49例,病理检查结果:肾上腺腺瘤45例,转移瘤4例。以病理检查结果作为“金标准”,对两种检查方法诊断准确率进行比较,并比较MRI和CT检查在肾上腺肿瘤患者定位、定性诊断情况。结果:增强MRI平扫诊断准确率(83.67%)明显高于CT平扫诊断准确率(57.14%),(χ^(2)=10.825,P<0.05)。49例患者经手术病例确诊,良性肾上腺肿瘤31例,恶性肾上腺肿瘤18例,对肾上腺肿瘤定位检出而言,CT检出准确率明显高于MRI准确率(P<0.05)。对于肾上腺肿瘤定性检出而言,MRI检出准确率又明显高于CT准确率(P<0.05)。良性肿瘤中,MRI图像清晰度优于CT,恶性肿瘤中两种检查方式差异无统计学意义(P<0.05)。结论:对于肾上腺肿瘤诊断,CT和MRI均存在一定优势和不足,CT可更为准确确定肿瘤位置,MRI可更为准确鉴别肿瘤良恶之分,故应根据患者实际情况选择适当的检查方式。

Objective:To explore the differential diagnosis value of dynamic enhanced MRI and CT for adrenal tumors.Methods:A total of 49 patients with adrenal tumor admitted to our hospital from October 2013 to September 2018 were selected.Pathological examination results showed that 45 patients had adrenal adenoma(18 cases of aldosterone adenoma,17 cases of cortisol adenoma,10 cases of non-functional adenoma),and 4 cases of metastatic tumor.Pathological examination results were taken as the"gold standard"to compare the diagnostic accuracy of the two examination methods,and to compare the location and qualitative diagnosis of adrenal tumor patients with MRI and CT examination.Results:The diagnostic accuracy of enhanced MRI plain scan was 83.67%,and that of CT plain scan was 57.14%.The diagnostic accuracy of MRI was significantly higher than that of CT,with statistically significant difference(χ^(2)=10.825,P<0.05).Among the 49 patients diagnosed by surgery,31 were benign adrenal tumors and 18 were malignant adrenal tumors.The location detection of adrenal tumors indicated that the detection accuracy of CT was significantly higher than that of MRI,with statistically significant differences(P<0.05).The qualitative detection of adrenal tumor showed that the accuracy of MRI was significantly higher than that of CT,and the difference was statistically significant(P<0.05).Among benign tumors,the sharpness of MRI images was better than that of CT,and there was no statistically significant difference between the two inspection methods in malignant tumors(P<0.05).Conclusion:For diagnosis of adrenal tumors,CT and MRI both have advantages and deficiencies.CT determines more accurately the tumor location,and MRI helps more accurately identify tumor to be benign or malignant.The option should be made according to the actual circumstance of patients.