肾上腺性征异常病变的CT和MRI诊断  

CT and MRI diagnosis of adrenal gland with sex characteristics abnormality

作　　者：刘广宇[1] 秦海燕[1] 孙浩然[1] 白人驹[1] 

机构地区：[1]天津医科大学总医院放射科,天津300052

出　　处：《医学影像学杂志》2005年第12期1084-1087,共4页Journal of Medical Imaging

摘　　要：目的:报告5例肾上腺性征异常病变的CT和/或MRI影像学表现,并结合文献讨论这两种影像检查方法对肾上腺性征异常病变的诊断价值和限度。方法:5例肾上腺性征异常病变中,先天性肾上腺皮质增生1例,皮质腺瘤和皮质癌各2例,除1例先天性肾上腺皮质增生外,余4例均经手术和病理证实。5例均进行了CT检查,其中1例皮质腺瘤还进行了MRI检查。结果:CT检查1例先天性肾上腺皮质增生表现为双侧肾上腺明显增大并边缘多发小结节;2例皮质腺瘤表现为肾上腺卵圆形肿块,密度较均一;2例皮质癌表现为肾上腺较大肿块,密度不均,1例有散在钙化,1例下腔静脉内有瘤栓。MRI检查1例皮质腺瘤,T1WI和T2WI信号强度类似肝实质,且在反相位上信号强度明显下降。结论:CT和/或MRI检查有助于肾上腺性征异常的诊断和鉴别诊断,对评估病人的预后和采取合理的治疗方案具有重要意义。Objective：To report CT and/or MRI findings in five cases with adrenal gland sex characteristics abnormality, and to discuss the diagnostic value and limitation of CT and MRI for them combined with the documents. Methods： Five cases with adrenal gland sex characteristics abnormality enrolled in ttds article, including one congenital adrenocortical hyperplasia which was proved by clinical study, two adrenocortical adenomas and two adrenocortical carcinomas with histopathological confirmation. All five cases underwent CT examination and one adrenocortical adenomas also underwent MRI examination. Results：On the CT imaging, one congenital adrenocortical hyperplasia presented with obvious enlargement of bilateral adrenal glands with nodular contours; two adrenocortical adenomas presented with ilomogenous oval mass; two adrenocortical carcinomas presented with heterogeneous larger mass in the adrenal gland, one case with calcification and another case with cancer embolus in the inferior vena cava. One adrenocortical adenomas showed iso-T1 and iso-T2 signal intensity contrast with hepatic parenchyma, and the signal intensity decreased obvioursly on the out phase images. Conclusion： CT and/or MRI is useful for the diagnosis and differential diagnosis of adrenal gland sex characteristics, and there are important significance for evaluating patient＇s prognosis and making optimal treatment plans.

关 键 词：肾上腺 性征异常 增生 腺瘤 皮质癌 体层摄影术 X线计算机 

分 类 号：R586.22[医药卫生—内分泌] R814.42[医药卫生—内科学]