CT在原发性醛固酮增多症患者肾上腺结节鉴别诊断中的价值

目的 探讨CT在鉴别诊断原发性醛固酮增多症患者肾上腺结节性质中的价值.资料与方法 回顾性分析184例经手术病理证实的原发性醛固酮增多症患者共190个肾上腺结节的CT表现及非载瘤肾上腺体部及侧肢厚度,比较醛固酮腺瘤与肾上腺增生结节的CT征象的发生率.结果 醛固酮腺瘤组与肾上腺增生结节组患者性别(P=0.040)、最大径(P=0.000)和边缘环形强化发生率(P=0.000)差异有统计学意义,但两组患者年龄(P=0.957)、结节数目(P=0.607)、侧别(P=0.667)、位置(P=0.612)、平扫CT值(P=0.835)以及3min绝对廓清率(P=0.057)、5min绝对廓清率(P=0.679)和7min绝对廓清率(P=0.512)差异无统计学意义.结论 原发性醛同酮增多症患者肾上腺腺瘤与增生结节在CT表现上存在很多重叠,但结节大小和边缘有无环形强化在鉴别腺瘤与增生结节中有重要意义.

Differential Diagnosis of Adrenal Nodules in Primary Aldosteronism on CT

Purpose To evaluate the diagnostic value of CT in characterization of adrenal nodules in primary aldosteronism. Materials and Methods CT features of 190 adrenal nodules in 184 surgically proved primary aldosteronism patients were reviewed and the thickness of non-lesion limps was measured. CT findings between group of aldosterone-producing adenoma and idiopathic hyperplasia were analyzed. Results There were statistical differences in gender (P = 0.040), maximum diameter (P = 0.000) and the existence of peripheral ring-shaped enhancement (P = 0.000) between aldosterone-producing adenoma group and idiopathic hyperplasia group. However, there was no difference in other features including age (P =0.957), average number of nodules (P =0.607), lateralization (P=0.667), location (P = 0.612), CT attenuation (P = 0.835) and absolute washout ratios at 3 min (P =0.057), 5 min (P = 0.679) and 7min (P = 0.512) between the two groups. Conclusion There are considerable overlapping in CT features between aldosterone- producing adenoma and idiopathic hyperplasia, however, the maximum diameter and the existence of marginal enhancement of the nodules are the main discriminating characteristics between the two groups.