外伤性肾上腺血肿的CT表现

目的:探讨外伤性肾上腺血肿的形成机制、CT诊断特征及临床应用价值。材料与方法:回顾分析19例经CT复查证实的外伤性肾上腺血肿CT扫描资料。结果:19例肾上腺血肿均发生在单侧,其中右侧16例、左侧3例。CT表现为肾上腺区域长椭圆形、类圆形肿块影,CT值50～69Hu,大多数血肿密度均匀、边缘清楚,长径2～4cm,长径与肾上腺前后径一致。合并肾上腺周围组织器官损伤15例,远离肾上腺的下腹部、盆腔损伤3例,单纯性右侧肾上腺血肿1例。本组19例均在外伤后5～192天内做了1～4次CT复查,其中11例从血肿中央开始密度减低,5例从血肿边缘开始密度减低,其余3例不具备上述特点。本组病例中只有2例追踪到6个月后复查血肿吸收消失,肾上腺形态逐渐恢复正常。结论:外伤性肾上腺血肿应首选CT检查,CT诊断具有特征性,有别于其它肾上腺占位,可避免不必要的腹部手术探查。

Traumatic Hematomas of the Adrenal Glands:CT Findings in 19 Cases

Purpose:To explore the traumatic adrenal hematoma formation mechanism,computed tomography(CT) diagnostic features,and clinical application.Materials and Methods:A retrospective review traumatic adrenal hematoma CT findings in 19 cases.Results:19 cases of adrenal hematoma occurred in unilateral,16 and 3 cases in right and left side, respectively.15 cases combined with organs injuries around adrenal gland,lower abdominal and pelvic injuries in 3 cases, and simple right adrenal hematoma in lcase.The CT scanning,1 to 4 times,ranged from 5 to 192 days in all cases.Typical CT findings were round or long oval hematoma expanding the adrenal gland(50 -69 Hounsfield units).The density of hematoma was uniformity and the diameters ranged from 2 to 4 cm along with the antero-posterior diameter of adrenal glands in most cases.The hematoma density gradually reduced starting from the center in 11 cases and from the edge in 5 cases.The remai- ning three cases had no these characteristics.After 6 months the hematoma absorbed thoroughly and the adrenal glands re- turned to normal shape in only 2 patients of this group.Conclusion:Traumatic adrenal hematoma should be preferred CT scanning,CT diagnosis of characteristic different from other adrenal masses,can avoid unnecessary exploratory abdominal surgery.