多层螺旋CT在肾上腺巨大肿瘤手术中的价值

目的 探讨多层螺旋CT(MSCT)在肾上腺巨大肿瘤手术中的价值. 资料与方法 采用GE 64层螺旋CT机,对超声或CT平扫提示腹膜后肾上腺区域8～15 cm的巨大占位性病变的8例患者,其中男5例,女3例,平均年龄38.2岁,进行双期增强扫描,利用获得的横断影像进行影像后处理. 结果 7例增强后肿块呈不均匀强化,占位明显,与周围的结构分界清楚,并发现常伴有一支或多支起源不同的供血动脉与肿块相连.7例患者成功地实施了肿瘤切除手术,术后随访3～12月未见肿瘤复发;另1例双侧肾上腺区域巨大肿块伴腹腔淋巴结肿大的患者,选择了放疗和化疗. 结论 应用MSCT对肾上腺巨大肿瘤进行双期增强扫描及影像后处理,不仅为肾上腺巨大肿瘤的定性诊断提供了重要的信息,对肾上腺巨大肿瘤术前的评估、术中的指导及术后的评价都具有积极的作用.

The Application of Multislice Spiral Computed Tomography in the Diagnosis of Huge Adrenal Tumor

Objective To evaluate multislice spiral CT (MSCT) in the diagnosis of huge adrenal tumor. Methods CT findings after contrast administration acquired by 64 row MSCT scanner in 8 patients with huge adrenal tumor from 8 centimeters to 15 centimeters suggested by ultrasound or CT were analyzed retrospectively.Results Seven cases showed a well-defined inhomogeneously enhancing mass with one or multiple feeding artery connecting the mass. The tumor was excised successfully in seven cases and no recurrence was found for follow-up of 3 to 12 months after surgery. Huge masses in bilateral adrenal gland regions with lymphadenopathy in the abdominal cavity were seen in 1 patient with radiotherapy and chemotherapy because of contraindication to surgery.Conclusions MSCT could provide additional information including feeding vessels to the tumor for preoperative treatment planning and follow-up after surgery.