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目的分析肾上腺皮质腺癌CT影像表现及诊断依据。方法收集2005年1月-2011年9月间经手术及病理证实的肾上腺皮质腺癌21例,回顾性分析其临床及CT影像资料。结果功能性皮质腺癌14例,无功能皮脂腺癌7例。肿瘤体积均较大,21例病变均单发,直径≥6 cm,密度不均,20例病变内有出血坏死;5例见钙化灶;增强实性部分明显强化;9例局部浸润及邻近组织受累,11例存在远处转移。术前准确诊断18例,误诊3例,均误诊为嗜铬细胞瘤,诊断符合率85.7%。结论 CT影像学检查是发现和准确诊断肾上腺皮质腺癌重要手段,通过病变CT特征并结合临床及实验室检查可作出准确诊断,但部分肾上腺皮质腺癌与嗜铬细胞瘤鉴别困难,确诊仍需依靠病理。
Objective To analyze the CT imaging findings and diagnosis basis of adrenocortical adenocarcinoma. Methods Twenty-one cases of adrenocortical adenocarcinoma confirmed by surgery and pathology from January 2005 to September 2011 were retrospectively analyzed. The clinical and CT imaging data were retrospectively analyzed. Results Functional cortical adenocarcinoma in 14 cases, 7 cases of non-functional sebaceous carcinoma. Tumor volume was larger, 21 lesions were single, diameter ≥ 6 cm, density is not uniform, hemorrhage and necrosis in 20 lesions; 5 cases of calcification, enhancement of solid part was significantly enhanced; 9 cases of local infiltration and adjacent tissue Involved, 11 cases of distant metastasis. Preoperative accurate diagnosis of 18 cases, misdiagnosed in 3 cases were misdiagnosed as pheochromocytoma, the diagnostic coincidence rate of 85.7%. Conclusion CT imaging examination is an important means to find and accurately diagnose adrenocortical adenocarcinoma. CT features of the lesions can be combined with clinical and laboratory tests to make accurate diagnosis. However, some adrenocortical adenocarcinomas and pheochromocytoma are difficult to identify. Rely on pathology.