肾上腺CT扫描诊断结核性Addison病的价值

 目的 总结Addison病肾上腺CT形态特点和诊断价值.方法 对1992～2006年临床诊断Addison病23例的肾上腺影像学特征进行回顾性分析,包括行CT平扫10例,B超13例和腹部X线检查8例,CT平扫中5例同时做B超检查.结果 (1)82.6 %(19/23)的患者临床诊断为结核性Addison病,男:女=6:13,平均42.8岁(17～72岁),其中68.4 %(13/19)有陈旧性肺结核病史;(2)10例患者行肾上腺CT平扫,结核性Addison病7例中表现干酪化期病变者5例,钙化期2例;其余3例为自身免疫性Addison病,肾上腺大小、形态和密度均正常,或萎缩,但均没有钙化灶;(3)典型干酪化期病变主要为肾上腺增大及钙化、或仅有增大或钙化;钙化期则表现为肾上腺增大伴片状或斑点状钙化;(4)超声显示干酪化期病变为肾上腺内部回声欠均匀,伴体积增大和(或)钙化;X线只能显示肾上腺区域钙化影征象.结论 CT检查有助于明确Addison病肾上腺病变的类型和分期,效果优于腹部超声和X线片检查.

Value of adrenal CT scanning in diagnosis of Addison's disease

Objective To identify the features and the diagnostic value of adrenal CT scanning in the patients with Addison's disease.Methods Imaging features of 23 patients with Addison's disease between 1992 and 2006 were retrospectively analyzed.Results Most patients developed Addison's disease due to adrenal tuberculosis,and about 68.4% of them had the history of pulmonary tuberculosis.Adrenal CT scanning of 10 cases was peiformed.Seven cases were diagnosed as having adrenal tuberculosis including five cases in caseous phase and two cases in calcified phase,and the others suffered from idiopathic Addison's disease.The typical tuberculous lesion was manifested as enlarged adrenal gland with calcification,or only enlargement or only calcification.On the contrary,the adrenal glands of idiopathic Addison's disease manifested neither enlargement nor calcification.It was shown that the internal echo was not evenly distributed,with augmented volume and/or calcification by the ultrasound,and only calcification was found in the radiograph.Conclusions Adrenal CT scanning is helpful to the categorization and staging of adrenal lesions in Addison's disease.