MSCT双期增强扫描鉴别肾上腺无功能嗜铬细胞瘤与腺瘤

目的 分析肾上腺无功能嗜铬细胞瘤和腺瘤的CT表现,为诊断与鉴别诊断提供参考.方法 回顾性分析经病理证实的肾上腺无功能嗜铬细胞瘤17例、腺瘤31例,对2组病例的影像表现进行统计分析,包括肿瘤大小、形态、密度、强化程度、是否见肿瘤血管及坏死囊变等.结果 嗜铬细胞瘤最大直径平均(52.2±20.2) mm,腺瘤最大直径平均(27.8±17.6) mm,差异有统计学意义(P<0.05).肿瘤实质部分平扫、动脉期、静脉期平均CT值嗜铬细胞瘤均高于腺瘤(均P<0.05).17例嗜铬细胞瘤,14例(82.4%)可在动脉期于肿瘤周围或肿瘤内见到肿瘤血管,12例(70.6%)可见坏死囊变,肿瘤边缘均未见环形或弧线样强化;31例腺瘤,3例(9.7%)见肿瘤血管,2例(6.5%)见坏死囊变,10例(32.3%)见环形或弧线样强化;差异均有统计学意义(均P<0.05).结论 肾上腺无功能嗜铬细胞瘤与腺瘤均具有特征性影像表现,MSCT双期增强扫描可为临床诊断和治疗提供帮助,增强扫描动脉期是否可见肿瘤血管是两者的鉴别点之一.

MSCT dual phase enhanced scanning in the differentiation of adrenalnon-functional pheochromocytoma from non-functional adenoma

Objective To analyze CT features of adrenal non-functional pheochromocytoma and non-functional adenoma and to provide reference for the diagnosis and differential diagnosis.Methods 17 cases of adrenal non-functional pheochromocytoma and 31 cases of non-functional adenoma confirmed by pathology were analyzed retrospectively.The imaging findings of two groups of cases were statistically analyzed, including size, shape, density, enhanced degree, visible tumor blood vessels, necrosis and cystoid variation and so on.Results The average diameter of the pheochromocytoma was (52.2±20.2) mm, and the average diameter of the adenoma was (27.8±17.6) mm, the difference was statistically significant (P<0.05).The average CT value of pheochromocytoma was higher than that of adenoma in plain, arterial and venous phases(all P<0.05).Of the 17 cases of pheochromocytoma, 14 cases (82.4%) can be seen tumor blood vessels in the arterial phase, 12 cases (70.6%) can be seen necrosis and cystoid variation, the margins of the tumors were no circular or arc-like enhancement;of the 31 cases of adenoma, 3 cases (9.7%) can be seen tumor blood vessels in the arterial phase, 2 cases (6.5%) can be seen necrosis and cystoid variation,10 cases (32.3%) can be seen circular or arc-like enhancement;all the differences were statistically significant (all P<0.05).Conclusion Adrenal non-functional pheochromocytoma and non-functional adenoma have characteristic imaging findings, dual phase enhanced scanning of MSCT is helpful for clinical diagnosis and treatment, one of the distinguishing points is to find tumor blood vessels in arterial phase.