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目的探讨动态增强CT对肾上腺乏脂性腺瘤(ALPA)与肾上腺转移瘤的诊断和鉴别诊断价值。方法分析37例(共43个病灶)ALPA与转移瘤CT平扫及动态增强特点,观察病灶形态、大小、边界、密度和周围特征,分析病变CT值变化规律,描绘每个病例ROI的T-D曲线(TDC),并根据对比剂峰值出现时间(PT)和相对廓清率(Washr),界定腺瘤与转移瘤特征性TDC类型。结果ALPA与转移瘤在形态、密度、周围结构、强化形态等CT征象上有差别,其TDC有明显差异,ALPA以快升快降型和缓升快降型为主,转移瘤以快升缓降型和缓升缓降型为主,两者鉴别诊断的敏感性、特异性分别为96.7%、92.3%。结论界定动态增强CT肿瘤ROI区域的TDC类型同时结合形态、边界、周围特征和强化形态,能明显提高对ALPA与转移瘤的鉴别诊断。
Objective To investigate the value of dynamic contrast-enhanced CT in the diagnosis and differential diagnosis of Adiponectasis-deficient adenoma (ALPA) and adrenal metastases. Methods The CT scan and dynamic enhancement features of ALPA and metastatic tumor in 37 cases (43 lesions) were analyzed. Morphology, size, border, density and surrounding features of the lesion were observed. The changes of lesion CT value were analyzed. The TD curve of ROI in each case (TDC), and define the characteristic TDC types of adenomas and metastases based on peak contrast time (PT) and relative wash-out rates (Washr). Results There was a difference in CT signs between ALPA and metastasis in terms of morphology, density, surrounding structure and enhanced morphology. TDC was significantly different between ALPA and metastasis. ALPA was mainly characterized by rapid ascending and descending pattern and rapid ascending pattern, Type and gentle descending type, the sensitivity and specificity of the differential diagnosis of the two were 96.7%, 92.3%. Conclusions The definition of dynamic enhanced CT in ROI region of TDC type combined with morphological, border, surrounding features and enhanced morphology, can significantly improve the differential diagnosis of ALPA and metastases.