肾上腺钝性损伤的CT分析

目的：探讨腹部钝性伤所致肾上腺损伤的CT征象。方法：回顾分析15例因腹部钝伤而行CT检查示有肾上腺损伤的资料，其中男性13例，女性2例。9例行CT平扫及增强检查，6例平扫；11例行CT随访。结果：15例肾上腺损伤均为单侧性损伤并伴同侧胸腹部损伤，位于右侧11例（73％），左侧4例，1例伴肾上腺肿瘤。10例CT主要表现为肾上腺区类圆形或卵圆形血肿（67％），3例（20％）表现为伤侧肾上腺增粗，1例（7％）表现为肾上腺区较弥漫的出血，1例原有肾上腺肿瘤存在。10例（67％）肾上腺邻近脂肪内出血呈条束状或局限性密度增高影，3例（20％）后肾周间隙的出血表现为类似膈脚增厚改变。结论：肾上腺损伤右侧远多于左侧，常伴有同侧胸腹腔和腹膜后损伤，肾上腺血肿有时需与肾上腺原发肿瘤相鉴别，鉴别主要方法是随访及增强CT检查。

CT Findings of Acute Adrenal Injury after Blunt Abdominal Trauma

Objective: To evaluate the CT signs of acute adrenal injury caused by blunt abdominal trauma. Methods; We retrospectively reviewed abdominal CT scans of 15 patients (13 of men,2 of women) with acute adrenal injury after blunt force trauma. 9 cases obtained non-enhanced and enhanced CT scans while 6 obtained nonenhanced CT scans,11 cases had follow-up CT scans. Results: All these 15 adrenal injuries were unilateral and were accompanied by ipsilateral thoracic or/and abdominal injuries, 11 cases (73%) were right-sided and 4 (27%)cases were left-sided, in CT scans, 10 cases (67%) appeared as discrete round or oval masses expanding the adrenal gland,3 cases (20%) appeared as uniform swelling of the gland, 1 case (7%) appeared as diffuse irregular hemorrhage obliterating the gland, 1 case was accompanied by a preexisting adrenal tumor. Associated CT findings such as stranding of the periadrenal fat caused by blood (10 of 15,67%), and posterior pararenal hemorrhage mimicking a thickened diaphragmatic crus (3 of 15,20%). Conclusion: Adrenal injury caused by blunt trauma is more common in the right-sided, and is often accompanied by ipsilateral thoracic or/and abdominal injuries. The follow-up CT scan and contrast-enhanced CT scan are two effective ways of differential diagnosis between adrenal hemorrhage and adrenal tumor.