B型超声对肾上腺醛固酮瘤238例术前定位诊断研究

本文报告了我院１９８５～１９９６年间临床疑诊为醛固酮瘤患者术前作过超声检查，术后经病理验证的连续住院患者２３８例。男７０例，均龄４４．２（１８～７２）岁，女１６８例，均龄４０．９（１１～７６）岁。外科在２２２例中摘除醛固酮瘤２２８个（６例为双瘤）。超声在其２１１例中检出肿瘤２１２个，漏诊１１例，５例同侧双瘤超声均只查出其中之一，故漏检肿瘤１６个。另１６例病理为增生，超声与其相符者为１３例，将３例误诊为肿瘤。本组超声检出最小瘤体的最大径为５ｍｍ，最大瘤体之最大径为８０ｍｍ，重量最轻为０．４ｇｍ，最重为２２５ｇｍ，敏感性、特异性及诊断正确率分别为９２．９８％、８１．２５％和９２．２１％。

Study on Diagnostic Value of Ultrasonography in Localizing 238 Cases with Suprarenal Aldosteronomas

From Jun.1985 to Dec.1996,238 cases with clinically suspected aldosteronomas were localized by ultrasonography(US)before surgery and were finally confirmed by pathology.70 were males,with mean age 44 2(18 70);168 were females,with mean age 40 9(11 76)years.In 222 cases,228 tumors(6 cases had 2 tumors in each case)were removed surgically.The other 16 cases had cortex hyperplasia.3 cases of them were misdiagnosed as tumors.So they were false positive.Among 222 cases,212 tumors were detected in 211 cases by US,So 11 cases with 11 tumors were false negative.There were 5 cases with double tumors at the same side of every case,but only one tumor in each case was detected.Therefore 16(11 5)tumors were false negative counted.The minimal delectable size of the aldosteronoma was found to be 0 5cm of its longest axis and 0 4gm of weight by US.The sensitivity,specificity and the diagnostic accuracy were 92 98%,81 25% and 92 21% respectively in this group.