肾上腺肿瘤的影像学特征对手术方式选择的影响(附64例报告)

目的提高肾上腺肿瘤的诊断与治疗水平。方法回顾分析2003年5月～2005年5月吉林省梅河口市医院及孙逸仙纪念医院泌尿外科收治的肾上腺肿瘤病人64例临床资料,总结影像学特征与手术方式选择的关系。结果B超和CT及MRI对肾上腺肿瘤的定位诊断率分别为85%和96%及92%。在皮质腺瘤、嗜铬细胞瘤及肾上腺皮质癌等不同的组织类型间,CT和MRI具有相对特异的表现;肿瘤直径<6cm的通过腹腔镜下成功切除。肿瘤直径大于6cm的和诊断为恶性肿瘤的采取开放手术成功切除。结论影像学检查可以提供肾上腺肿瘤的定位和部分定性诊断,对手术方式的选择提供良好依据。腹腔镜手术是目前肾上腺良性肿瘤切除的金标准。直径大于6cm的肿瘤和考虑恶性的肿瘤最好采用开放手术。

Effects on imaging feature of adrenal tumors for selection of operative manners(Areport of 64 cases)

Objective To improve the levels of diagnosis and treatment to adrenal tumors. Methods From May 2003 to May 2005,the clinical data of 64 cases with adrenal tumors were analyzed retrospectively. And it's imaging features and selection of operative manner were summarized. Results The level diagnosis rate in the ultrasonography,CT scan and MRI were 85%,96% and 92% respectively. Adrenocotical adenoma,pheochromocytoma and adrenocortical adenocarcinoma had their own specific imaging features on CT and MRI imaging respectively. Tumors which were less than 6 cm in diameter were resected successfully by laparoscope. Tumors more than 6 cm in diameter and malignant tumors diagnosed were resected by open operation. Conclusion Imaging examination may provide level diagnosis and partial qualitative diagnosis for adrenal tumors. The resection of adrenal benign tumors by laparoscop has been served as "golden standard surgery". But the tumors more than 6cm in diameter and malignant tumors should be resected by open surgery.