CT导向下经皮细针穿刺化学消融术治疗肾上腺肿瘤

目的探讨CT导向下经皮细针穿刺化学消融术治疗肾上腺肿瘤的价值。方法CT导向下经皮细针穿刺化学消融术治疗37例肾上腺肿瘤，其中无功能性腺瘤11例、皮质醇腺瘤5例、醛固酮腺瘤7例、转移瘤14例(20个病灶)。病灶瘤径小于3cm者注射无水乙醇治疗，大于3cm者注射50％冰醋酸治疗。结果10个瘤径小于3cm的良性肿瘤治疗后仅残留少许纤维影；16个大于3cm的良性肿瘤均有进行性缩小；8个转移瘤灶缩小1／3以上，5个转移瘤灶治疗后瘤径无变化但瘤体内存在大面积低密度坏死区，7个转移瘤灶有增大并合并其他部位多发转移。全部功能性肾上腺肿瘤治疗后血液中激素水平恢复到正常范围。结论CT导向下经皮细针穿刺化学消融术治疗肾上腺肿瘤是1种效果显著、创伤性小、操作简便的介入方法。

Percutaneous chemoablation of adrenal tumors with fine needles under the CT guidance

Objective To evaluate the efficacy of percutaneous chemoablation of adrenal tumors with fine needles under the CT guidance. Methods Thirty-seven cases of adrenal tumors were treated with chemoablation under CT guidance.Among them,there were 11 cases of non-functional adenoma,5 cases of corticosteroid adenoma,7 cases of aldosteronoma,and 14 cases of metastasis (20 foci).Results After therapy,10 benign tumors with diameter less than 3 cm were nearly disappeared.The sizes of 16 benign tumors with diameter over 3 cm gradually decreased.There was a significant reduction in the volumes of 8 metastases,large area of necrosis in 5 metastases,and the sizes of another 7 metastases were enlarged and with multi-metastasis.The normalization of hormone plasma levels was noted in all cases of functional adenoma. Conclusion CT-guided percutaneous chemoablation of the adrenal tumors is an effective,less invasive,and easy manipulated procedure.