肾上腺区肿瘤与肿瘤样病变的CT诊断与鉴别

目的探讨肾上腺区不同来源的肿瘤与肿瘤样病变的CT特征，提高诊断准确率和鉴别诊断能力。方法回顾性分析158例经手术、病理或临床追踪证实的肾上腺区肿瘤与肿瘤样病变的CT资料，总结肾上腺区肿瘤与肿瘤样病变的来源、形态、大小、密度、边缘及强化特点等特征，对相关特征进行分析。结果其中130例为肾上腺来源，分别为肾上腺皮质腺瘤52例、髓样脂肪瘤6例、嗜铬细胞瘤14例、囊肿3例、节细胞神经瘤3例、转移瘤36例、皮脂癌8例、结核3例、畸胎瘤5例；28例为非肾上腺来源，分别为腹膜后脂肪肉瘤8例、胃憩室3例、胰腺假性囊肿5例、肝囊性转移瘤5例、囊性肾癌7例。结论螺旋CT对肾上腺区肿瘤与肿瘤样病变的定位及定性较准确，CT表现均有一定的特征性，对临床诊治有很大帮助。

CT diagnosis and differential diagnosis of adrenal tumor and tumor-like lesions

ObjectiveTo explore the CT features of tumor and tumor-like lesions from different origins of the adrenal area, and to improve the related diagnosis and differential diagnosis.MethodsCT findings of 158 cases with adrenal tumors or tumor-like lesions confirmed by operation, pathology or clinical follow-up were retrospectively analyzed. Features of these adrenal tumor and tumor-like lesions, including origin, shape, size, density, and enhancing features, were summarized.ResultsThe tumor or tumor-like lesions in 130 cases were originated from adrenal gland, including 52 cases of adrenocortical adenoma, 6 cases of adrenal myelolipoma, 14 cases of pheochromocytoma, 3 cases of cyst, 3 cases of ganglioneuroma, 36 cases of metastatic tumor, 8 cases of sebaceous carcinoma, 3 cases of tuberculosis, and 5 cases of teratoma; and 28 cases were from non-adrenal sources, including 8 cases of retroperitoneal liposarcoma, 3 case of gastric diverticulum, 5 case of pancreatic pseudocyst, 5 case of hepatic cystic metastasis, and 7 case of cystic renal carcinoma.ConclusionSpiral CT is accurate in the positioning and characterization of adrenal gland tumors and tumor-like lesions, and the CT findings have certain characteristics, thus both helpful to clinical diagnosis and treatment.