急性肾上腺血肿的螺旋CT诊断价值

目的 探讨螺旋CT对急性肾上腺血肿的诊断价值,方法回顾性分析8例经CT检查、随访观察证实的外伤性肾上腺血肿,1例经手术证实非外伤性血肿的CT表现特点.9例病人中男6例,女3例.急性期8例均有CT平扫,1例有平扫加增强扫描;亚急性期8例有平扫加增强扫描.结果 单侧肾上腺血肿8例（右侧6例,左侧2例）,双侧1例.急性期肾上腺血肿的主要CT表现为肾上腺区类网形、卵圆形、类三角形高密度影,肾上腺周围脂肪出血9例,肾周脂肪囊出血2例,肾前筋膜增厚3例,伴随其他脏器损伤7例.CT追踪观察,8例外伤性肾上腺血肿伤后8～9d血肿密度盯开始缓慢均匀减低,大小无变化,肾上腺周围出血逐渐吸收;1例18d后复查血肿密度均匀减低.略有缩小,肾上腺周围出血基本吸收;增强血肿均无强化,8例肾上腺呈条状强化,内外支受压.结论 肾上腺血肿的CT表现有一定的特征性,动态随访可为诊断与鉴别诊断提供可靠依据.

Spiral CT Diagnosis of Acute Adrenal Hematoma

Objective To approach the diagnositic value of CT in adrenal hematoma. Methods CT scanning materials of 8 cases of traumatic adrenal hematoma and l case nontraumatic adrenal hematoma confirmed by operation were retrospectively analyzed.Out of the 9 cases,6 cases were males and 3 were females.8 cases of acute stage all have plain CT, I case has plain and enhanced scanning.8 cases of subacute stage have pla!n and enhanced scanning.Results 8 cases were unilateral adrenal hematoma,among them 6 cases were located at right side and 2 cases lefi.l case was bilateral.The principal CT manifestations of acute adrenal hematoma were round,oval and triangle like high dense lesion in adrenal area.9 cases were hemorrhage of periadrenal fat tissue,2 cases were hemorrhage of perirenal adipose capsule.3 cases were anterior anadesma of kidney.7 cases were accompanied by other organ injury.Observation of CT follow-up after 8 to 9 days found that hemorage denses were reduced slowly and uniformity of 8 cases of traumatic adrenal hematoma, but the sizes were not changed,and hemorrhage of periadrenal were gradually absorbed.Hemorage dense decreased steadily and slightly contracted and hemorrhage of periadrenal mainly absorbed in 1 case after 18 days recheck.Adrenal hematomas have no enhancement, adrenals were strip like enhanced in 8 cases and external and interal branches were compressed.Conclusion CT manifestations of adrenal hematoma have invariably feature and dynamic follow-up can offer reliable evidence for diagnosis and differential diagnosis.