肾上腺髓样脂肪瘤的CT诊断

目的分析和探讨肾上腺髓样脂肪瘤的CT表现特征及其诊断价值。方法回顾性分析21例经手术病理证实的肾上腺髓样脂肪瘤的CT表现。分析病变位置、形状、大小和病变内有无钙化、出血、脂肪和假包膜及增强后的表现特征等。结果本组共21例，均为单发，15例位于右侧。肾上腺，6例位于左侧。肿瘤最大径线为1．7—11cm，肿瘤多呈圆形或类圆形，病灶内部含有脂肪和髓样成分，CT表现因病灶内所含成分的比例不同而有所差异，其中16例呈脂肪与软组织混合密度，3例以脂肪密度为主，2例以软组织密度为主，无1例肿瘤内部有出血。3例肿瘤边缘可见钙化，所有病例假包膜完整，CT增强后脂肪成分未见明显强化，软组织成分轻度强化。结论肾上腺髓样脂肪瘤有比较典型的CT表现，通过CT平扫及增强扫描一般能做到术前诊断，部分不典型病变术前诊断比较困难，确诊仍依靠病理。

CT diagnosis of adrenal myelolipoma

Objective Toanalyze the CT features and diagnosis value of adrenal myelolipoma. Methods The CT features of 21 cases with adrenal myelolipoma pathologically confirmed were analyzed retrospectively. CT images were scored for the location, shape and size of each myelolipoma and the presence of calcification, hemorrhage, fat, pseudocapsule and contrast manifestation. Results 21 adrenal myelolipoma were found in 21 patients, of which 15 were in the right adrenal gland and 6 in the left adrenal gland. The tumor size ranged from 1.7 cm to 1 lcm. The tumors were usually round or similar to round. The tumors consisted of varying proportions of lipid and myeloid tissue. The CT appearance of myelolipomas varied depending on the proportions of tissue components they contained. 16 cases showed mixed fat and soft tissue density, 3 cases mainly fat density and 2 cases mainly soft tis- sue density. On enhanced CT images the fat contents were not enhanced and the soft contents were mildly enhanced. None of the tu- mors were with internal hemorrhage. Three cases had calcification in the edge of the tumors. All the cases had complete pseudocapsule. Conclusion The CT findings of adrenal myelolipoma are typical characteristic and in general can be diagnosed preoperatively through the CT plain scan and enhanced scan. But some atypical lesions are difficult to diagnosis before operation with CT scans and the diagnosis depends on pathological sections.