副神经节瘤的影像学诊断(附31例分析)

目的：旨在提高副神经节瘤的诊断水平。方法：收集经手术病理证实的副神经节瘤37例，共43个病灶，其中32个病灶为肾上腺髓质嗜铬细胞瘤，10个病灶为肾上腺外副神经节瘤，1个颈部副神经节瘤。36例行CT检查，21例行MRI检查。回顾性分析其CT或MRI征象。结果：肾上腺髓质嗜铬细胞瘤与肾上腺外副神经节瘤肿瘤常大于5．0cm，易发生出血、坏死和囊变。CT表现为中等密渡，MRI表现为T1WI呈类似于肝组织的信号强度，T2WI高于肝组织的信号强度，增强扫描有明显强化。1例颈部副神经节瘤位于颈总动脉分叉处，密度均匀，无坏死囊变，其强化特征是强化程度与颈部血管接近。结论：副神经节瘤的CT和MRI表现具有一定特征，结合临床表现多可明确诊断。

Imaging diagnosis of paraganglioma

Objective:To improve clinical diagnostic ability for paraganglioma.Methods:CT scan was performed in 36 patients and MRI were performed in 21.CT and MRI findings in 37 cases (43 lesions) with pathologically-proved paraganglioma were retrospectively analyzed.Of 43 lesions,32 were adrenal pheochromocytoma, 8 were extra-adrenal paraganglioma and 1 was carotid body paraganglioma.Results:The largest diameters of adrenal pheochromocytoma and extra-adrenal paraganglioma were more than 5cm.Necrosis and cystic degeneration were common findings(23/43).CT findings were of middle density.The signal intensity on T_1WI was similar to that of hepatic parenchyma,while on T_2WI was marked hyper-intensity.Usually, the tumorous parenchyma showed strong enhancement.A case of carotid body paraganglioma showed uniform intensity,with no necrosis and cystic formation.The feature and degree of enhancement were similar to that of the carotid artery.Conclusion:The CT and MRI findings of paraganglioma carry certain characteristics.For most cases,a reliable diagnosis can be made when combined with clinical information.