原发性肾上腺皮质腺癌的CT表现

目的 总结原发性肾上腺皮质腺癌的CT表现,以提高其诊断准确性.方法 回顾性分析经手术或穿刺活检后病理证实的原发性肾上腺皮质腺癌17例的影像资料,所有的患者术前均做CT平扫及动脉期和门静脉期双期增强扫描.结果 全部病例单发,右侧9例,左侧8例,直径3～17 cm;6例肿瘤内可见点状、条索状或结节状钙化,10例见较大范围的液化、坏死和囊变区,4例肿瘤以实质为主伴小囊状低密度区.平扫肿瘤CT值为32～47 HU,平均37.3 HU.动脉期增强扫描,肿瘤实性成分强化较明显,肿瘤实质成分CT值在37～72 HU,平均50.9 HU,8例见显著强化的不规则的肿瘤血管.门静脉期肿瘤实质成分强化更明显,强化范围扩大,实质部分CT值为37～98 HU,平均83.4 HU.结论 原发性肾上腺皮质腺癌的CT表现具有一定的特征性,CT双期增强扫描在原发性肾上腺皮质癌的诊断中有重要的诊断价值.

CT findings of primary adrenocortical carcinoma

Objective Toexplore the CTfeatures ofprimaryadrenocortical carcinoma(PACC)soas toimprove the diagnostic ac- curacy of the disease.Methods All the 17 cases with PACC comfirmed by pathology after surgery or biopsy were enrolled in the study.All the patients underwent CT plain scan and double phases(arterial and portal vein phases)enhancement scan before operation.The CT findings were reviewed and analysed retrospectively.Results All the cses were solitary.9 of 17 cases were located in the right side,8 in the left side.The diameter of the tumors was 3-17 cm.Punctiform and nodular calcification were found in 6 cases.Large area necrosis and cystic change were found in 10 cases.4 cases demostrated solid mass with multiple small cystic change.The attenuations of CT plain scan were 37.3 HU(32-47 HU).In CT arterial phase enhancement scan,the tumors enhanced obviously.The attenuations in solid part of CT arterial phase enhancement scan were 50.9 HU(37-72 HU).The irregular tumor vessels were found in 8 cases.The attenuations and en- hanced exten of CT portal vein enhancement scan were higher than that of CT arterial phase enhancement scan.The attenuations in solid part of CT portal vein phase enhancement scan were 83.4 HU(37-98 HU).Conclusions The CT findings of PACC is potential characteristic.CT double phases enhancement scan plays an important role in the diagnosis of the disease.