肾上腺髓样脂肪瘤的CT和MRI表现  

CT and MRI findings of the adrenal myelolipoma

作　　者：王东烨[1] 李勇[1] 蔡兆熙[1] 沈君[1] 

机构地区：[1]广州中山大学孙逸仙纪念医院放射科,510120

出　　处：《岭南现代临床外科》2012年第6期448-450,共3页Lingnan Modern Clinics in Surgery

基　　金：广东省自然科学基金(9151008901000001)

摘　　要：目的探讨CT和MRI对肾上腺髓样脂肪瘤的诊断价值。方法回顾性分析手术病理证实的12例肾上腺髓样脂肪瘤的CT、MRI表现。结果 12例肾上腺髓样脂肪瘤,右侧7例,左侧4例,双侧1例,共13个病灶。肿瘤最大径为2～9cm,边界清楚,呈圆形、分叶状或不规则形;肿瘤的CT和MRI表现与瘤内脂肪组织和类骨髓组织所占的比例相关;脂肪组织在CT表现为低密度,CT值为-120Hu～-30Hu,MRIT1WI和T2WI上都呈高信号,脂肪抑制序列上信号下降;类骨髓组织CT值为20Hu～45Hu,在MRI上与肝脏的信号强度相似;增强扫描,瘤内脂肪组织不强化,类骨髓组织可呈轻度至中度强化。1例肿块见出血灶,3例肿块见钙化灶,4例肿块见坏死灶,1例肿块伴发于左侧肾上腺腺瘤。结论肾上腺髓样脂肪瘤的CT、MRI表现具有一定的特征性,有助于做出定位和定性诊断。Objective To investigate the diagnostic value of CT and MRI for adrenal myelolipoma.Methods The CT or MRI images of 12 adrenal myelolipomas confirmed by operation and pathology were retrospectively analyzed.Results Among 12 cases of adrenal myelolipoma,7 cases originated from the right adrenal,4 cases from the left adrenal and 1 case had bilateral tumors.The tumor size ranged from 2 cm to 9cm in the maximal diameter with well-defined round,lobulated or irregular shape.CT and MRI findings of the adrenal myelolipoma were related with the predominance of fat tissue and bone marrow tissue components in the tumor.On CT scan,fat tissue components showed low density,and CT value ranged from-120Hu to-30Hu.On MRI,fat tissue components showed high signal in T 1 WI and T 2 WI as well as hypointensity on fat suppression sequence.CT value of bone marrow tissue components ranged from 20Hu to 45Hu.On MRI signal intensity of bone marrow tissue components was similar to that of liver.Fat tissue components had no enhancement,and bone marrow tissue components showed mild-to-moderate enhancement.Tumor bleeding was observed in 1 case,calcification was in 3 cases,and tumor necrosis was present in 4 cases.One tumor associated with left adrenal adenoma.Conclusion CT and MRI findings of the adrenal myelolipoma show some features,which are helpful for the clinical diagnosis.

关 键 词：肾上腺 髓样脂肪瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R736.6[医药卫生—肿瘤]