原发性肾上腺恶性肿瘤的CT、MRI评价

目的探讨CT和MRI对原发性肾上腺恶性肿瘤的诊断及鉴别诊断价值. 资料与方法对26例经手术和病理证实的原发性肾上腺恶性肿瘤的CT、MRI表现进行回顾性分析,包括肾上腺皮质癌17例,恶性嗜铬细胞瘤7例,原发性恶性淋巴瘤、恶性间皮瘤各1例. 结果 CT和MRI定位准确性分别是86%和95%,定性的准确性为90%和95%.原发性肾上腺恶性肿瘤CT、MRI扫描的典型表现为肿瘤体积较大（直径〉5.0 cm）,形态不规则,边界不清或侵犯周围结构,内部结构不均匀,内有不规则坏死区或出血灶,增强后肿瘤呈不均一明显强化;77%（20例）肿瘤侵犯周围结构和/或远处转移. 结论 CT、MRI能诊断大部分原发性肾上腺恶性肿瘤,并确定其侵犯范围,两者对原发性肾上腺恶性肿瘤的诊断价值相似,后者有利于肿瘤的定位.

CT and MRI Diagnosis of Primary Malignant Adrenal Neoplasms

Objective To discuss the value of CT and MRI in the diagnosis and differential diagnosis of primary malignant adrenal neoplasms.Materials and Methods The CT and MRI features of 26 cases with primary malignant adrenal neoplasms verified by operation and pathology were investigated retrospectively.The tumors included adrenal cortical carcinoma in 17 cases,malignant pheochromocytoma in 7 cases,primary malignant lymphoma and malignant mesothelioma in 1 casesrespectively.(Results The) accuracies of location and qualitatively diagnosed were 86%,95% and 90%,95% for CT and MRI respectively.On CT and MRI,The characteristic findings of primary malignant adrenal neoplasms were presented with a large soft tissue mass(>5.0cm),with irregular configuration,blurry margin or invasion surrounding structures,heterogeneous appearances with internal hemorrhage and necrosis,and inhomogeneous enhancement.77%(20 cases) tumors had the surrounding structures invasion and/or distant metastases.Conclusion CT and MRI have the similar diagnostic efficacy for the primary malignant adrenal neoplasms,and could diagnose the most of the tumors and estimate its invasive extension.MRI is useful in the tumor location.