肾上腺偶发瘤66例报告

目的 探讨肾上腺偶发瘤的临床特征和诊治措施.方法 回顾性分析66例肾上腺偶发瘤的临床资料.结果 定位诊断准确率:B超84.3%,CT 100%,MRI 100%;定性诊断准确率:B超30.0%,CT 75.5%,MRI 79.2%;手术60例:皮质腺瘤32例,肾上腺囊肿6例,髓性脂肪瘤5例,嗜铬细胞瘤5例,肾上腺转移性癌3例,皮质癌3例,神经节瘤3例,神经鞘瘤 1例,血肿1例, 肾上腺皮质结节增生1例.结论 肾上腺肿瘤筛查首选B超、CT、MRI,定位诊断准确;定性诊断应综合肿瘤大小、影像学特征、患者年龄及内分泌功能测定.疑诊嗜铬细胞瘤或定性诊断不明需手术时,应按嗜铬细胞瘤行术前准备.

Report of 66 cases of adrenal incidentalomas

Objective To investigate the clinical features,diagnosis and therapy of adrenal incidentalomas. Methods The data of 66 cases of adrenal incidentalomas were retrospectively analyzed. Results The accuracy rates of localization detected by B-Ultrasound,CT scan and MRI were 84.3%,100% and 100% respectively. The accuracy rates of qualitative diagnosis by B-Ultrasound, CT scan and MRI were 30.0%,75.5% and 79.2% respectively. There were 60 cases underwent operation and the postoperative pathological examination confirmed that there were 31 cases of adrenal cortical adenoma, 6 cases adrenal cyst, 5 myelolipoma, 5 pheochromocytoma, 3 adrenal cortical carcinoma, 3 metastatic carcinoma, 3 ganglioneuroma, 1 adrenal neurilemmoma, 1 adrenal hematoma, and 1 nodular hyperplasia of adrenal cortex. Conclusions Ultrasonography is the first choice of scanning adrenal incidentaloma. However the CT scan and MRI are satisfactory in localization of the tumour. The qualitative diagnosis of adrenal incidentaloma will depend on the diameter, imaging features of tumors, the age of patients, and endocrine examination.