螺旋CT对肾上腺肿瘤的诊断及评价
Spiral CT in diagnosis of adrenal tumors
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摘要: 目的: 总结肾上腺肿瘤的CT表现及特征,评价螺旋CT对肾上腺肿瘤的诊断和鉴别诊断价值。方法: 回顾性分析28例经手术病理证实的各类肾上腺肿瘤的CT征象,提出诊断与鉴别诊断要求。结果: 皮质腺瘤6例,大小、密度中等;皮质腺癌4例,肿块较大不规则,密度不均匀,中心有低密度坏死;嗜铬细胞瘤9例,单侧瘤体较大,平扫密度不均匀,实质部分强化明显;髓质脂肪瘤3例,低密度的脂肪显示是其特征性CT表现;转移瘤5例,多为肺癌转移,肿块呈圆形或不规则形,密度不均匀,中等强化;肾上腺囊肿1例,CT值低而均匀,壁薄规则。结论: 肾上腺肿瘤CT表现有一定的特征性,认真分析,结合临床及生化检查,可对其作出定性诊断。Abstract: Objective: To summarize the CT features of adrenal tumors and to assess the value of spiral CT in diagnosis and differential diagnosis of the disease.Methods: The CT findings of 28 cases with pathologically proved adrenal tumors were analyzed retrospectively and the key points in diagnosis were presented.Results: Six cases had adenoma of middle size and density;4 had adenocarcinoma with irregular mass of uneven density and central low-density necrosis;9 cases had pheochromocytoma with a larger mass of heterogeneous density with marked enhancement;3 cases of myelolipoma were characterized by low density areas for fat contents;5 cases of metastasis,almost all of which resulted from the pulmonary cancer,displayed a round or irregular mass of heterogeneous density with middle-level enhancement;1 case of adrenal cyst presented low and heterogeneous density with thin and regular cyst wall.Conclusions: Adrenal tumors have certain CT characteristic signs.CT findings combined with clinical and laboratory data can provide correct diagnosis.