腹膜后肾上腺外嗜铬细胞瘤的MDCT诊断

目的分析腹膜后肾上腺外嗜铬细胞瘤多层螺旋CT的影像表现。方法回顾性分析11例经手术病理证实的腹膜后肾上腺外嗜铬细胞瘤的CT影像资料,全部病例术前均行多层螺旋CT平扫及双期CT增强扫描,测量CT值变化并行统计学分析。结果 11例均为单发肿块,全部位于腹主动脉周围,腹主动脉左侧9例(81.82%,9/11),腹主动脉右侧1例(9.09%,1/11),腹主动脉前方邻近肠系膜血管1例(9.09%,1/11);CT平扫表现为境界清楚的圆形或椭圆形肿块10例(90.9%,10/11),1例呈轻度分叶状,肿块直径3cm～10cm,平均5.1cm,瘤体密度欠均匀,伴有不规则囊变和坏死。静脉注射非离子型碘对比剂增强后11例病灶均呈明显不均匀强化,内部有无强化低密度囊变区。分析肿块平扫与双期增强的CT值差异有统计学意义。结论肾上腺外嗜铬细胞瘤常位于腹主动脉旁,无临床症状。CT增强显示腹主动脉旁孤立类圆形富血供软组织肿块并囊变,应高度警惕嗜铬细胞瘤的可能,提示外科做进一步检查和充分的术前准备。

Multi-detector CT diagnosis of retroperitoneai extra-adrenal pheochromocytoma

Objective To observe the CT findings of abdominal extra-adrenal pheochromocytoma. Methods CT features of 11 patients with retroperitoneal extra-adrenal pheochromocytoma confirmed by surgery and histology were retrospective- ly analyzed. All cases underwent plain MDCT scan and double-phase CT enhancement examination before operation. Measurement of the changes of CT values and statistical analysis were done. Results All the 11 cases were single lesion which located around abdominal aorta, 9（81. 820%, 9/11） in the left side, 1 （9.09%, 1/11） in the right side, and 1 （9.09%. 1/11） was ahead of the abdominal aorta and beside the mesenteric vessels, 10 cases（90, 9%）, 10,/11） showed round or oval masses with well-delined margin on plain CT scan. I case showed mild lobulated. The average diameter of the tumors was 5. 1 cm between 3 cm to i0 cm. ,The lesions showed heterogeneous density with irregular cystic and necro- sis. Uneven marked enhancement was noted in all 11 cases after administration of non-ionic iodine contrast media. Cystic areas with low density demonstrated within the masses. There was statistically significant on the difference of mass CT values among plain CT scan and double phases CT enhancement. Conclusion Retroperitoneal extra-adrenal pheocbromo- cytomas often locate around the abdominal aorta without clinical symptoms. It should be highly alert to the possibility of pheochromoeytoma that an isolated oval hypervascular soft tissue mass showed around the abdominal aorta on CT enhance- ment. Suggestions of further examination and adequate oreoperative areoarations are usuallv useful