肾上腺肿瘤的CT诊断及鉴别诊断

目的分析肾上腺肿瘤的CT诊断特征,探讨鉴别依据.方法搜集从1995年至今的16例经手术病理证实的肾上腺肿瘤和随访证实的3例肺癌并双侧肾上腺转移瘤,分析其大小、边缘、形态、密度及强化特征.结果皮质醇腺瘤中等大小,中等密度的均质块影,增强后中度强化;醛固酮腺瘤小且密度低,近半数成负值,强化不明显;无功能性腺瘤常生长较大,呈规则的圆形或椭圆形,多数病灶密度均匀,呈略低密度,增强后亦呈轻度强化;嗜铬细胞瘤较大,密度不均匀,强化明显;髓质脂肪瘤显示为低密度的脂肪密度区,内有网状结构并中度强化为其特征性表现;肾上腺囊肿为边缘光滑、均质水样的囊性占位,增强无明显强化;肾上腺皮质腺癌表现为不规则、分叶状、密度不均匀、环状强化的块影:肾上腺转移瘤肿块较大,密度均匀或不均匀,强化较明显.结论 CT是目前最常用的肾上腺肿块定位和定性的检查方法.高分辨率CT不但可以清楚的显示肿瘤对邻近器官的局部侵害或区域淋巴结的转移情况,还能准确区别腺瘤与增生及良、恶性的内部细节.

CT Diagnosis and Differential Diagnosisof Adrenal Tumor

Objective To analyze the characteristics of adrenal tumor s CT diagnosis and explore the differential basis.Methods 16 cases of adrenal tumor confirmed by surgery and pathology and 3 cases of lung cancer followed with adrenal metastasis from 1995 to now were analyzed in the tumor s size,margin,morphology,density and enhanced character.Results The cortisol adenoma had middle size and density uniform mass with middle enhanced character.The aldosterone adenoma had small size,low density and slight enhanced character.The nonfunctional adenoma had large size,regular round-like,uniform and low density,slight enhanced character.The chromaffin tumor had large size,inhomogeneous density and strong enhanced character.The medulla lipoma had low density and reticular enhanced character.The adrenal cyst had smooth margin and uniform watery mass.The adrenal cortical adenocarcinoma had irregular,lobular unhomogeneous density and ring enhanced mass.The metastasis tumor had large size and strong enhanced character.Conclusion The CT is a common method to detect the adrenal tumor in location and quality.The high differential CT might not only show the relative tissue involved or lymph node,but also differentiate the detail of inside benign or malignance.