3．0T磁共振扩散加权成像对肾上腺原发肿瘤的诊断价值

目的评估3．0TMR扩散加权成像（DWI）及ADC值对肾上腺原发肿瘤的诊断价值。方法回顾性分析48例经手术病理证实的肾上腺原发肿瘤患者的术前DWI图像，用Mann—Whitneyu法对不同病理类型肿瘤的ADC值进行统计学比较，并采用受试者工作特征曲线（ROC）分析。结果肾上腺神经节细胞瘤（5例）、（良性）嗜铬细胞瘤（7例，其中1例为双侧）、皮质腺瘤（21例）、原发恶性肿瘤（包括7例皮质癌及1例恶性嗜铬细胞瘤）及髓脂肪瘤（7例）的ADC值依次为：（1．948±0．357）×10^-3mm2／s）、（1．666±0．547）×10^-3mm2／s、（1．434±0．430）×10^-3mm2／s、（0．951±0．144）×10^-3mm2／s及（0．764±0．209）×10^-3mm2／s。除外髓脂肪瘤，以ADC值≤1．08×10。mm。／s为阂值，诊断肾上腺原发恶性肿瘤的特异度为87．50％、灵敏度为85．29％、准确率为85．71％。肾上腺原发恶性肿瘤与神经节细胞瘤、嗜铬细胞瘤及皮质腺瘤ADC值之间差异均有统计学意义（尸值分别为0．003、O．006及0．001），。肾上腺原发恶性肿瘤与髓脂肪瘤ADC值之间差异无统计学意义。结论 3.0TMR扩散加权成像可应用于。肾上腺原发良、恶性肿瘤的诊断，而ADC值能够对不同病理类型肿瘤的鉴别提供有价值的信息。

Diffusion-weighted MR imaging in assessment of primary adrenal tumors at 3.0 T

Objective： To evaluate the value of diffusion weighted imaging （DWI） and apparent diffusion coefficient （ADC） at 3.0 T MR in primary adrenal tumors. Materials and Methods： DWI images of 48 patients with primary adrenal tumors proved by surgical pathology were retrospectively reviewed. ADC values of tumors were statistically analyzed. Results： The mean ADC value of neoplasms were listed below： ganglioneuromas （n=5）, 1.948±0.357×10^-3 mm2/s; benign pheochromocytomas （n=7, including 1 case with bilateral tumor）, 1.666±0.547×10^-3 mm2/s; cortical adenomas （n=21）, 1.434±0.430×10^-3 mm2/s; primary adrenal malignant tumors（n=8, including 7 adrenal cortical carcinomas and 1 malignant pheochromocytoma）, 0.951±0.144×10^-3 mm2/s; myelolipomas （n=7）, 0.764±0.209×10^-3 mm2/s. Except myelolipomas, given ADC value of 1.08×10^-3 mm2/s as a threshold for diagnosing primary adrenal malignant tumor, the sensitivity, specificity and accuracy were 87.50%, 85.29% and 85.71%, respectively. There were significant differences between primary adrenal tumors and ganglioneuromas, benign pheochromocytomas and cortical adenomas （P=0.003, 0.006 and 0.001, respectively）. However, no statistic difference was found between primary adrenal malignant tumors and myelolipomas. Conclusion： 3.0 T MR DWI could be used in diagnosis of primary adrenal tumors, and ADC value might be helpful in differentiating the adrenal pathology.