肾上腺偶发瘤——CT评价及误诊分析

CT diagnosis of adrenal incidentaloma

目的 :分析并总结肾上腺偶发瘤的CT诊断及鉴别诊断要点 .方法 :收集 1990～ 2 0 0 0年间经手术及病理证实的35例肾上腺偶发瘤的CT及临床、病理资料 .结果 :嗜铬细胞瘤 9例 ,腺瘤 7例 ,转移瘤 5例 ,髓性脂肪瘤 5例 ,节细胞神经瘤 3例 ,腺癌、脂肪瘤、囊肿、神经纤维瘤、神经鞘瘤及间叶瘤各 1例 .其中良性 2 5例 (71% ) ,恶性 10例 (2 9% ) ;CT诊断明确者 18例 (5 1% ) ,误诊 8例 (2 3% ) ,不能明确诊断者 9例(2 6 % ) .结论 :①肾上腺偶发瘤良性多见 ;②髓性脂肪瘤、囊肿、脂肪瘤可明确诊断 ;③转移瘤、嗜铬细胞瘤、腺癌较易诊断 ;④少、罕见偶发瘤大多不能明确诊断 ,须依赖组织学检查 ;⑤腺瘤。

AIM: To analyze and summarize misdiagnostic and differential CT features of adrenal incidentaloma. METHODS: CT data of 35 cases of adrenal incidentaloma confirmed by operation and pathology were analyzed. RESULTS: Nine cases were pheochromocytoma, 7 cases adenoma, 5 cases myolipoma, 5 cases ganglineuroma, 3 cases, 1 case adenocarcinoma, 1 case lipoma, 1 case cyst, 1 case neurofibroma, 1 case neurilemoma and 1 case mesenchymoma. Of them, benign tumors were 25 cases and malignant were 10 cases. Eight cases were misdiagnosed and 9 cases were given no final diagnosis by CT. CONCLUSION: ① Most of adrenal incidetaloma are benign.② Adrenal myolipoma, lipoma and cyst can be accurately diagnosed by CT. ③ Most of adrenal metastasis, pheochromocytoma and adenocarcinoma can be diagnosed By CT. ④ Most of rare adrenal incidetaloma are difficult to be diagnosed by CT. ⑤Adrenal adenoma, pheochromocytom and unilateral metastasis are often misdiagnosed.