良、恶性乏脂质性肾上腺肿瘤的动态MRI检查

目的：探讨MRI动态增强检查技术对乏脂质性肾上腺肿瘤良、恶性的鉴别诊断价值。方法：经手术和临床证实的29例共33个乏脂质性肾上腺肿瘤行MRI平扫并于注药后1min、2min、3min、5min、7min和9min时间点行动态增强检查,分别观察病变的增强程度并获取乏脂质性肾上腺肿瘤的廓清率（Wash）和时间-信号强度曲线（T-S curve）,以评估良、恶性肿瘤间是否存在统计学差异。结果：T-S曲线分Ⅰ~Ⅴ五种类型。良性乏脂质性肿瘤的特征曲线为Ⅰ、Ⅱ型和Ⅳ型;恶性乏脂质性肿瘤的特征曲线为Ⅲ型和Ⅴ型（P=0.000）,肾上腺良性乏脂质性肿瘤的廓清率高于恶性肿瘤,两者之间差异有统计学意义（P=0.006）,在5min延迟点诊断价值较大,Wash≥23%提示为良性肿瘤。结论：MRI动态增强检查技术对乏脂质性肾上腺肿瘤良、恶性的鉴别诊断具有较高价值。

The dynamic contrast-enhanced MRI in adrenal benign and malignancy lipid-poor neoplasms

Objectlve：To analyze the value of dynamic contrast-enhanced MR/in the differentiation from adrenal benign and malignancy lipid-peor neoplasms. Methods：29 cases with 33 adrenal lipid-poor neoplasms verified by surgical and pathological were studied. Plain and enhanced MR/scans were performed in all above mentioned lesions with the same parameters scans beginning at 1 rain, 2 rain, 3 rain, 5 min, 7 min, and 9 min after initial injection of contrast material. And then, characteristic features of dynamic contrast-enhanced MR/of adrenal lipid-peor neoplasms including time-signal curve （T-S） and washout rate （Wash） were analyzed. Results： T-S curves were divided into type I to V. Type I , Ⅱ and Ⅳ were belonged to typical curves of benign neoplasms, whereas type Ⅲ and Ⅴ were belonged to malignancy neoplasms（ P = 0.0130）. There was significant difference in Wash between malignancy neoplasms from benign neo- plasms （ P =0.006）. Wash was higher in benign neoplasms than that in malignancy neoplasms, while the effect of diaglnesis with Wash ≥23%, especially in the delay at 5 rnin. Conclusion： Dynamic contrast-enhanced MRI has an inlportant value in diagnosis of lipid-poor neoplasms, especially in differentiation from benign neoplasms from malignancy neoplasms.