18例肾上腺结核患者的临床及CT特征分析

Analysis of 18 cases of adrenal tuberculosis on clinical and imaging characteristics

目的:探讨肾上腺结核的临床及CT影像学特征。方法:分析2012年1月~2015年6月新疆维吾尔自治区人民医院18例肾上腺结核患者的临床资料,男9例,女9例,平均年龄53.2岁(22~72岁)。双侧14例,单侧4例。对肾上腺结核的临床表现及影像学CT检查资料进行分析。结果:临床表现常见为肾上腺皮质功能减退症状,皮肤色素加深8例,乏力8例,消瘦6例。10例(55.6%)肾上腺结核患者出现肾上腺皮质功能减退症状。6例合并其他部位活动性结核,其中4例肺结核;2例肾结核。CT的主要影像表现为:肾上腺增粗13例,肾上腺出现钙化17例,肿块样改变7例,结节样改变4例。结论:肾上腺结核明确诊断时常已累及双侧肾上腺,临床表现多以肾上腺皮质功能减退症状为主;肾上腺结核的CT主要影像学表现为肾上腺钙化、肾上腺增粗、出现肾上腺肿块样或结节改变。

Objective:To study the clinical and CT characteristics of the patients with adrenal tuberculosis.Methods:The clinical data of 18 patients who were diagnosised as having adrenal tuberculosis from January 2012 through June 2015 in Department of Urology in People's Hospital of Xinjiang Uygur Autonomous Region were analyzed.There were 9males and 9females with an average age of 53.2years old(22-72 years old).There were 14 cases of bilateral involvement,and 4cases of unilateral.Results:The most common clinical manifestations were symptoms of adrenal cortex hypofunction:hyperpigmentation of skin(8cases);weakness(8cases);weight loss(6cases).Ten(55.6%)cases had the manifestation of adrenal cortex hypofunction.There were 6cases of extra adrenal involvements:4cases of pulmonary tuberculosis;2cases or renal tuberculosis.The most common imaging characteristics of CT were adrenal gland enlargement(13cases);calcification(17cases);mass change(7cases);nodular change(4cases).Conclusions:When the diagnosis of adrenal tuberculosis was made,bilateral involvements were seen usually.The most common clinical manifestations were symptoms of adrenal cortex hypofunction.The most common imaging characteristics of CT were calcification,adrenal gland enlargement,mass or nodular change.