肾上腺结核的增强CT表现特征与临床病程的相关性

目的探讨肾上腺结核的增强CT表现特征与临床病程的相关性，以提高该病的影像诊断水平。方法经临床证实的肾上腺结核30例，在CT强化图像上观察肾上腺的位置、大小、形态、密度以及强化特征，并结合临床和病理资料加以分析，采用Cochran Armitage趋势检验进行统计分析。结果肾上腺结核累及双侧共27例（90．0％），单侧3例（10．0％）。肾上腺肿块样增大13例，轻度或中度增大17例，轮廓仍保持完整。肾上腺增大密度均匀2例（6．7％），不均匀增大28例（93．3％）。周边强化16例（53．3％），钙化17例（56．7％）。经抗结核治疗后的6例复查CT示，5例双侧增大的肾上腺体积缩小或恢复正常，其内低密度消失，新出现点状钙化2例。钙化多见于临床后期，17例钙化中，病程〉12个月者10例，存在随病程增长而递增的分布趋势（x^2=7．47，P〈0．05），而周边强化则多见于临床早期，16例中有11例临床病程≤12个月，存在随病程增长而递减的分布趋势（x^2=6．60，P〈0．05）。结论肾上腺结核CT具有特征性表现，与临床病程存在一定的相关性，为临床治疗及疗效判断提供指导。

Adrenal tuberculosis: contrast-enhanced CT features with clinical correlation

Objective To investigate the correlation between specific features on contrast-enhanced CT and its clinical findings of adrenal tuberculosis so as to improve the diagnostic accuracy of the disease. Methods Contrast-enhanced CT features in 30 patients with documented adrenal tuberculosis were retrospectively evaluated blindly for the features of location,size,morphology,attenuation and enhancement patterns on CT images,and compared with clinical and pathological materials.Results The common CT manifestations were as follows:enlargement of the adrenal glands in all 30 cases(bilateral 90%,mfilateral 10%)including mass-like enlargement in 13 cases and enlargement but the contours preserved in 17 cases, heterogeneity(28 cases,93.3%),calcification(17 cases,56.7%),and low attenuation in the center with peripheral enhancement(16 cases,53.3%)of the lesions.After antituberculosis chemotherapy, 5 cases of enlarged adrenal glands decreased in size or returned to normal size and configuration,with disappearance of the central low attenuation and new appearance of dot-like calcification in 2 cases.Cochran Armitage trend test showed there was an increasing tendency of calcification rate with clinical duration(X~2= 7.47,P<0.05),but a decreasing tendency of peripheral enhancement(X~2=6.60,P<0.05).Conclusions Adrenal tuberculosis has some characteristic manifestations on CT,which had some correlations with its clinical findings and can guide clinical treatment and evaluation.