皖南医学院学报
皖南醫學院學報
환남의학원학보
ACTA ACADEMIAE MEDICINAE WANNAN
2013年
4期
327-329
,共3页
肾上腺疾病%体层摄影术%螺旋CT
腎上腺疾病%體層攝影術%螺鏇CT
신상선질병%체층섭영술%라선CT
adrenal disease%tomography%spiral computed tomography
目的：评价16层螺旋CT扫描对肾上腺疾病的诊断价值，以提高对肾上腺病变的认知。方法：分析38例肾上腺疾病患者的16层螺旋CT检查影像资料，并随访获得病理结果或经过临床验证，获得病变的精确位置、形状、大小和病变内有无钙化、出血、脂肪和假包膜及增强后的表现特征。结果：38例患者中手术切除33例、穿刺活检2例、临床证实3例。病检结果为腺瘤20例（其中伴出血、坏死及囊变4例），CT表现为低密度结节，轻中度渐行性强化；髓性脂肪瘤5例，为含脂性混杂密度，轻度强化；囊肿2例（假性囊肿1例、内皮囊肿1例），为液性密度、可伴钙化包膜，没有强化；嗜铬细胞瘤3例，多为囊实性包块，实性部分强化明显、有渐行性增强趋势；皮质腺癌1例，为界限模糊的等低混杂密度，不均匀强化；节细胞神经瘤1例，为软组织样密度、轻度强化，呈“蜡滴样”改变；血肿1例，为高于正常肝实质密度、较均匀，不强化；转移瘤3例，多为双侧、表现同皮质腺癌，常有原发肿瘤病史；结节状皮质增生2例，实质密度与肾上腺肢体相仿、呈结节状外突改变，增强后与肾上腺肢体同步强化。结论：16层螺旋CT扫描对肾上腺病变的定位、定性诊断均有重要价值，有助于肾上腺病变的明确诊断，但仍有部分不典型病例的确诊需要依赖于病理。
目的：評價16層螺鏇CT掃描對腎上腺疾病的診斷價值，以提高對腎上腺病變的認知。方法：分析38例腎上腺疾病患者的16層螺鏇CT檢查影像資料，併隨訪穫得病理結果或經過臨床驗證，穫得病變的精確位置、形狀、大小和病變內有無鈣化、齣血、脂肪和假包膜及增彊後的錶現特徵。結果：38例患者中手術切除33例、穿刺活檢2例、臨床證實3例。病檢結果為腺瘤20例（其中伴齣血、壞死及囊變4例），CT錶現為低密度結節，輕中度漸行性彊化；髓性脂肪瘤5例，為含脂性混雜密度，輕度彊化；囊腫2例（假性囊腫1例、內皮囊腫1例），為液性密度、可伴鈣化包膜，沒有彊化；嗜鉻細胞瘤3例，多為囊實性包塊，實性部分彊化明顯、有漸行性增彊趨勢；皮質腺癌1例，為界限模糊的等低混雜密度，不均勻彊化；節細胞神經瘤1例，為軟組織樣密度、輕度彊化，呈“蠟滴樣”改變；血腫1例，為高于正常肝實質密度、較均勻，不彊化；轉移瘤3例，多為雙側、錶現同皮質腺癌，常有原髮腫瘤病史；結節狀皮質增生2例，實質密度與腎上腺肢體相倣、呈結節狀外突改變，增彊後與腎上腺肢體同步彊化。結論：16層螺鏇CT掃描對腎上腺病變的定位、定性診斷均有重要價值，有助于腎上腺病變的明確診斷，但仍有部分不典型病例的確診需要依賴于病理。
목적：평개16층라선CT소묘대신상선질병적진단개치，이제고대신상선병변적인지。방법：분석38례신상선질병환자적16층라선CT검사영상자료，병수방획득병리결과혹경과림상험증，획득병변적정학위치、형상、대소화병변내유무개화、출혈、지방화가포막급증강후적표현특정。결과：38례환자중수술절제33례、천자활검2례、림상증실3례。병검결과위선류20례（기중반출혈、배사급낭변4례），CT표현위저밀도결절，경중도점행성강화；수성지방류5례，위함지성혼잡밀도，경도강화；낭종2례（가성낭종1례、내피낭종1례），위액성밀도、가반개화포막，몰유강화；기락세포류3례，다위낭실성포괴，실성부분강화명현、유점행성증강추세；피질선암1례，위계한모호적등저혼잡밀도，불균균강화；절세포신경류1례，위연조직양밀도、경도강화，정“사적양”개변；혈종1례，위고우정상간실질밀도、교균균，불강화；전이류3례，다위쌍측、표현동피질선암，상유원발종류병사；결절상피질증생2례，실질밀도여신상선지체상방、정결절상외돌개변，증강후여신상선지체동보강화。결론：16층라선CT소묘대신상선병변적정위、정성진단균유중요개치，유조우신상선병변적명학진단，단잉유부분불전형병례적학진수요의뢰우병리。
Objective:To assess the diagnostic value of 16-section helical computed tomography(CT) scans for characterization of adrenal lesions ,and improve the knowledge of radiologists on this entity .Methods:Thirty-eight pa-tients underwent 16-section spiral CT sans for the adrenal lesions ,and the im-aging data were analyzed concerning the lesion location ,modality,size and le-sion with or without calcification ,hemorrhage ,fat attenuation and pseudo-cap-sule as well as specificity on contrast-enhanced images , and compared with the pathological and clinical findings .Results:The total 38 cases were con-firmed surgically(n=33),by biopsy(n=2) and clinical manifestation(n=3) with adrenal lesions.Pathological findings showed that 20 were adrenal ad-enomas(presence of hemorrhage,necrosis and cystic change in 4)that were characterized by low density nodules and mild-to-moderate gradually intensi-fied modality on CT image.Five were adrenal myelolipoma with mixed density containing fat attenuation and lightly reinforced feature .Two cyst cases ( one pseudo-cyst and one endothelial cyst ) displayed liquid density ,with calcified capsule and without reinforcement .Three cases of pheochromocytomas exhibi-ted most cystic-solid mass with clear reinforcement ,tending to increase in sol-id part.One sebaceous gland carcinoma showed mixed density with poorly de-fined boundaries and no reinforcement .One ganglion cell tumor demonstrated soft tissue density,mild reinforcement and a “drip wax sample” change.One hematoma was featured by uniform ,higher density than normal liver and no reinforcement .Three cases of metastatic tumor ( often with primary tumor his-tory ) presented bilaterally and mimicked sebaceous carcinoma on CT imaging.The density of protruding nodules in 2 with nodular adrenal hyper-plasia resembled adrenal gland body with synchronous reinforcement . Conclusion:16-section spiral CT scans can be valuable in localizing the le-sion and final confirmation of the adrenal disease ,yet,some atypical cases still depend on pathological examination .
