社区医院常规体检中胸部CT对肾上腺疾病的诊断价值

目的探讨社区医院常规体检中肾上腺疾病的顺位排序,并评估胸部CT对肾上腺疾病的诊断价值。方法选取2018年5月至2019年5月我院常规胸部CT体检时发现肾上腺异常征象的90例患者作为研究对象,分析其一般资料、临床和生化资料以及胸部CT结果。对肾上腺CT征象异常疾病进行顺位排序,并进一步收集排序前两位疾病的病理诊断结果,在此基础上评估胸部CT对排序前两位肾上腺疾病的诊断价值。结果 90例肾上腺异常CT征象患者中,肾上腺结节增生48例,肾上腺皮质腺瘤34例,肾上腺钙化2例,肾上腺髓样脂肪瘤2例,其他各种因素造成影像假象4例,占比依次为53.3%、37.8%、2.2%、2.2%、4.4%,其中肾上腺结节增生与肾上腺皮质腺瘤所占比例最大。肾上腺皮质腺瘤经病理诊断为24例,CT诊断正确为21例,准确率为87.5%;肾上腺结节性增生经病理诊断为34例,CT诊断正确为31例,准确率为91.2%,CT对肾上腺结节性增生的诊断准确率略高于肾上腺皮质腺瘤(P>0.05)。结论社区医院常规体检中肾上腺疾病的顺位排序依次为肾上腺结节增生、肾上腺皮质腺瘤、肾上腺钙化、肾上腺髓样脂肪瘤,并且胸部CT对肾上腺结节增生、肾上腺皮质腺瘤的诊断准确率较高,常规体检中胸部CT对于肾上腺疾病的诊断具有积极意义。

Diagnostic value of chest CT in adrenal diseases during routine physical examination in community hospital

Objective To explore the sequence of adrenal diseasesin routine physical examination in community hospital,and to evaluate the diagnostic value of chest CT in adrenal diseases. Methods From May 2018 to May 2019, 90 patients with adrenal abnormalities found in the routine chest CT examination were selected as the study objects, the general data, clinical and biochemical data and chest CT results were analyzed. The abnormal CT signs of adrenal diseases were ranked in order.The pathological diagnosis results of the top two diseases were further collected. On this basis, the diagnostic value of chest CT for the top two adrenal diseases was evaluated. Results Among 90 cases of abnormal adrenal CT signs, there were 48 cases of adrenal nodule hyperplasia, 34 cases of aderenal cortical adenoma, 2 cases of adrenal calcification, 2 cases of adrenal medullary lipoma and 4 cases of image false caused by other factors, accounting for 53.3%, 37.8%, 2.2%, 2.2% and4.4% respectively. Among them, adrenal nodule hyperplasia and aderenal cortical adenoma account for the largest proportion.There were 24 cases with aderenal cortical adenoma diagnosed by pathology, CT diagnosis is correct in 21 cases, the accuracy rate was 87.5%;34 cases with adrenal nodule hyperplasia diagnosed by pathology, CT diagnosis is correct in 31 cases, the accuracy rate was 91.2%. The accuracy rate of CT diagnosis of the adrenal nodule hyperplasia was slightly higher than that of the aderenal cortical adenoma(P >0.05). Conclusion The order of adrenal diseases in routine physical examination in community hospitals is adrenal nodule hyperplasia, adrenal cortical adenoma, adrenal calcification and adrenal medullary lipoma. The chest CT in diagnosis of adrenal nodule hyperplasia and adrenal cortical adenoma has higher diagnostic accuracy. Chest CT in routine physical examination is of positive significance for the detection of adrenal diseases.