肾上腺节细胞神经瘤的CT表现与病理对照分析

目的：探讨肾上腺节细胞神经瘤（ganglioneuroma GN）的CT影像学表现，并与病理所见对比，旨在提高对该病的认识及诊断准确率。方法回顾性分析经病理证实的12例肾上腺GN的CT表现。男9（9/12）例，女3（3/12）例，年龄21-59岁，平均35.08岁；均为单发，其中3（3/12）例仅行CT平扫，9（9/12）例行CT平扫及增强检查。结果11（11/12）例肾上腺节细胞神经瘤位于右侧，1（1/12）例位于左侧，大小范围从1.1cm×1.6cm-8.8cm×7.0cm，CT平扫9（9/12）例表现为类圆形、类椭圆形低密度团块，均低于肌肉密度，且密度均匀，边缘及边界清晰，均未见囊变、坏死及钙化；3（3/12）例较大者呈不规则形，并呈钻缝样生长，可包绕邻近组织及器官；增强动脉期均未见强化，静脉期稍有强化，平衡期轻度强化，均呈延迟渐进性强化，其中4例体积较大者延迟期呈小斑点状强化，强化幅度均〈15HU，包膜均有较明显强化。大体病理肿瘤呈结节状或分叶状，界限清楚，呈橡皮样硬度，切面灰白或棕黄色，镜下见神经节细胞呈多角形，核大呈梭形或圆形，有明显核仁，胞浆红染，增生的神经纤维呈波浪状或编织状排列；其中4例病理镜下不典型，加做免疫组化确诊。结论肾上腺GN的CT影像表现具有一定特异性， CT平扫加增强检查能较好地显示肿瘤的形态、内部结构、血供及生长方式情况，明确肿瘤的范围，及与毗邻结构的关系情况，这些特征均有助于与肾上腺的其他肿瘤鉴别，确诊需要结合病理检查结果。

CT imaging features of adrenal ganglioneuroma in correlation with pathologic analysis

Objective To Study CT imaging features of adrenal ganglioneuroma and compared with histologic features,in order to improve the understanding of the disease and the preoperativediagnosis accuracy. Methods The imaging features on routine plain 3 cases and dual phase contrast enhanced 9 cases CT of 12 cases with adrenal ganglioneuroma confirmed pathology were retrospectively analyzed,9 cases were male and 3cases female,age from 21 to 59 years old,the average age was 35.08 years;All the lesions were located in unilateral. Results Section 11 cases adrenal glioma cells located in the right,1 case in the left side, the size range from 1.1cm ×1.6cm-8.8cm ×7.0cm,9 cases of lesions on CT scan was characterized by low density shadow class round,oval,were lower than the density of muscle tissue,and uniform density,edge and boundary clear,internal capsule,necrosis and calcification was not found. 3 cases of bulky lesions showed irregular shape,and growth in seam drill samples,can be adjacent tissues and organs. Enhancement were not seen arterial enhancement,Venous phase slightly strengthen,equilibrium phase Slight enhancement,were delayed gradual strengthening,strengthening amplitude are less than 15HU,Lesions of coating are obviously Strengthened,Among them 4 cases of large volume delay wais small punctate,Naked eye can see the shape of the tumor was nodular or lobulated,Tumor entity similar rubber hardness,Border and clear,the tangent plane to present grey or brown. Micro-scopically ganglion cells are polygonal,nuclear big show fusiform or circular,with obvious nucleolus,cytoplasm red dye,hyperpla-sia of the nerve fibers were wavy or weave pattern;Among them 4 cases of pathological microscopically not typical,and immuno-histochemical diagnosis. Conclusion CT imaging features of adrenal ganglioneuroma has certain specificity. CT scan and en-hanced examination can well display the shape and texture of tumor,nternal structure,the blood supply and growing methods,clear the scope of the tumor and its relationship with the adja