CT对原发醛固酮增多症亚型的诊断价值

目的探讨CT在原发醛固酮增多症亚型醛固酮瘤和肾上腺增生鉴别诊断中的价值。方法回顾性分析94例肾上腺肿瘤患者的CT影像资料,与手术组织病理进行对照,分析术前CT诊断醛固酮瘤及肾上腺增生的准确率,比较CT诊断直径≥1.5cm与直径〈1.5cm醛固酮瘤的准确率。结果手术组织病理诊断原发醛固酮增多症79例,其中肾上腺醛固酮瘤62例,肾上腺皮质增生17例;CT术前诊断醛固酮瘤的准确率为85.5%（53/62）,诊断肾上腺增生的准确率为64.7%（11/17）,二者比较差异有统计学意义（P〈0.05）;CT诊断直径≥1.5cm的醛固酮瘤的准确率为92.0%（46/50）,诊断直径〈1.5cm醛固酮瘤的准确率为58.3%（7/12）,二者比较差异有统计学意义（P〈0.05）。结论 CT术前诊断醛固酮瘤的准确率高于肾上腺增生,但对直径〈1.5cm的醛固酮瘤术前正确诊断率较低。

Diagnosis value of CT scan to the subtypes of primary aldosteronism

Objective To evaluate the value of CT scan to the differentiate diagnosis of subtypes of primary aldosteronism（aldosteronoma and adrenal hyperplasia）.Methods Ninety-four patients with the primary aldosteronism were retrospectively analyzed the CT findings,and were compared with the histopathological results to analyze the preoperative diagnostic accuracies of CT for aldosteronoma and adrenal hyperplasia,and to compare the diagnosis accuracies of CT for aldosteronoma≥1.5cm and 〈1.5cm in diameter.Results In 79 patients with histopathologically confirmed primary aldosteronism,60 were aldosteroneonoma and 17 were adrenal hyperplasia.The diagnosis accuracies of CT were 85.5%（53/62）and 64.7%（11/17）for aldosteronoma and adrenal hyperplasia,showing a significant difference（P〈0.05）.The diagnosis accuracies of CT were 92.0%（46/50）and 58.3%（7/12）for aldosteronoma≥1.5cm and1.5cm in diameter,showing a significant difference（P〈0.05）.Conclusion The diagnosis accuracy of CT is higher for aldosteronoma than that for adrenal hyperplasia,but is lower for aldosteronoma1.5cm in diameter.