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目的分析肾上腺肿瘤病变的CT特征,探讨螺旋CT扫描对肾上腺病变的诊断及鉴别诊断价值。方法回顾性分析23例共25个肾上腺肿瘤的CT表现,与手术病理对照。结果 23例肾上腺占位病变中,10例肾上腺腺瘤,皮质腺瘤6例,醛固酮腺瘤4例,边界清楚,密度较均匀,有包膜,增强扫描轻度或中等度强化,其体积以小到中等大小为主,1例皮质腺瘤双侧均见瘤体。6例嗜铬细胞瘤,形态较规则,边界清楚,密度欠均匀,增强扫描明显不均匀强化,体积较大。3例转移瘤,其中1例双侧发病,边界清,密度欠均,体积较小,呈环状强化或中度强化。2例皮质癌形态不规则,边界欠清,密度不均匀,边缘实性部分不均匀明显强化。2例髓质脂肪瘤体积巨大,呈混杂密度,边界清楚,实性部分中度强化,脂性成分不强化。结论螺旋CT扫描对肾上腺肿瘤病变的诊断及鉴别诊断具有重要价值,并有助于选择治疗方案和判断预后。
Objective To analyze the CT features of adrenal tumor lesions and to evaluate the value of spiral CT in the diagnosis and differential diagnosis of adrenal lesions. Methods The CT findings of 23 cases of 25 adrenal tumors were retrospectively analyzed and compared with the surgical pathology. Results In 23 cases of adrenal space lesions, 10 cases of adrenal adenoma, 6 cases of cortical adenoma and 4 cases of aldosterone adenoma had clear border, uniform density, enveloped and enhanced mild or moderate enhancement scanning. The volume of Small to medium-sized, 1 case of bilateral cortical adenoma tumor. 6 cases of pheochromocytoma, the morphology is more rules, the border is clear, the density is less uniform, enhancement scan obviously uneven enhancement, larger volume. 3 cases of metastases, including 1 case of bilateral disease, border clearance, density less homogeneous, smaller, was ring-shaped enhancement or moderate enhancement. Two cases of cortical carcinoma were irregular in shape, the border was not clear, the density was uneven, and the edge solid part was unevenly and obviously strengthened. 2 cases of medullary lipoma huge volume, were mixed density, clear boundary, the solid part of the moderate enhancement, fat composition is not enhanced. Conclusion Spiral CT scan is of great value in the diagnosis and differential diagnosis of adrenal neoplasm, and it is helpful to choose the treatment plan and prognosis.