动态增强CT检查对肾上腺腺瘤与非腺瘤的鉴别诊断价值

Evaluation of Dynamic Enhanced CT Scanning in the Differentiation of Adrenal Adenoma with Non-adenoma

目的 探讨动态增强CT检查技术对肾上腺腺瘤与非腺瘤的鉴别诊断价值并优选出有意义的参数 ,以进一步明确两者的鉴别诊断标准。资料与方法 对 4 4例共 4 9个肾上腺肿瘤先平扫再行动态增强CT检查 ,观察以肿瘤的CT绝对值、绝对开始廓清率及相对开始廓清率作为标准鉴别肾上腺腺瘤与非腺瘤的诊断价值。结果 延时 3min ,以 36 %的绝对开始廓清率或 35 %的相对开始廓清率分别与CT绝对值 5 8HU相结合作为标准 ,对腺瘤有较高的诊断价值 ,对于腺瘤中的乏脂质性腺瘤与非腺瘤的鉴别诊断也具有同样的价值。结论 以肿瘤的廓清率与延时增强后的CT绝对值作为联合标准 ,能明显提高腺瘤的诊断价值。

Objective To evaluate dynamic enhanced CT in differentiating adrenal adenoma from non adenoma, to determine the optimal scanning parameters and to establish the differentiation criteria.Materials and Methods Forty four patients with 49 adrenal masses were enrolled into this study. Both plain and dynamic enhanced CT scanning were performed in all patients. The absolute enhancement attenuation, the absolute and relative washout percentage of initial enhancement of each lesion were measured and compared between adenoma group and non adenoma group.Results When the judging criteria were assumed as the threshold of absolute washout percentage being 36% or relative washout percentage being 35%, and the absolute enhancement attenuation being 58 HU at the time of 3 minutes delayed, dynamic enhanced CT scanning showed high accuracy for the diagnosis of adenomas and for the differentiation of fat poor adenomas with non adenomas.Conclusion The standard based on the washout percentage and the delayed absolute enhancement attenuation is of great value in differentiating adrenal adenoma with non adenoma.