原发性肾上腺皮质腺癌的CT诊断价值  

CT findings of primary adrenocortical carcinoma

作　　者：周建军[1] 曾维新[1] 周康荣[1] 王建华[1] 曾蒙苏[1] 程伟中[1] 周梅玲[1] 纪元[2] 陆锦标[3] 

机构地区：[1]复旦大学上海医学院附属中山医院放射科,上海200032 [2]复旦大学上海医学院附属中山医院病理科,上海200032 [3]复旦大学上海医学院附属肿瘤医院病理科

出　　处：《中华放射学杂志》2006年第10期1023-1026,共4页Chinese Journal of Radiology

摘　　要：目的分析原发性肾上腺皮质腺癌(ACC)的 CT 表现及其动态增强特征,以提高其诊断准确性。方法回顾性分析经手术病理证实的 ACC 11例,术前均经 CT 平扫、动脉期(30 s)和门静脉期(70～80 s)扫描,复习 CT 扫描表现并和手术病理作对照。结果 11例 ACC 中,右侧5例,左侧6例。直径4.1～16.0 cm,其中,<5.0 cm 者2例,5.0～10.0 cm 者4例,>10.0 cm 5例;肿瘤境界清楚3例,邻近脂肪间隙见条索状异常密度影3例,邻近实质脏器受侵犯5例。肿瘤实质成分平扫、动脉期和门静脉期 CT 值分别为21.9～46.7 HU(平均35.3 HU)、30.5～65.8 HU(平均47.1 HU)和52.6～97.0 HU(平均74.2 HU)。肿瘤中央坏死形成假囊肿4例,网络状改变6例,实质为主伴小囊变1例;6例网络状改变者动脉期可见显著强化的不规则肿瘤血管。结论 ACC 具有较明显的形态学和血液动力学特征,动态增强扫描尤其是动脉期扫描有明显的诊断价值。Objective To explore the imaging features and dynamic CT findings of primary adrenocortical carcinoma and evaluating its clinical value. Methods All 11 cases patients with primary adrenocortical carcinoma confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation. Contrast injection was done by using nonionic Omnipaque at a flow rate of 3 ml/s with a power injector. The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results. Results Five of ll lesions were located in the right adrenal gland, 6 in the left. The diameter of the tumors was 4. 1-16. 0 cm with 2 cases 〈5.0 cm, 4 cases 5.0--10.0 cm and 5 cases 〉 10. 0 cm. The attenuation of the plain scans, two phases contrast scans was 21.9--46. 7 HU （with a mean value of 35.3 HU） , 30. 5--65.8 HU（ mean value 47. 1 HU ） , and 52.6-- 97.0 HU（ mean value 74. 2 HU） , respectively, Four were in the shape of capsule, 6 reticular, 1 slightly inhomogeneous masses. The irregular tumor vessels of 6 reticular masses were seen in the artery phase. Conclusion The dynamic CT features of primary adrenocortical carcinoma were obvious, dynamic SCT scans could suggest the diagnose.

关 键 词：癌 肾上腺皮质 肾上腺 体层摄影术 X线计算机 

分 类 号：R736.6[医药卫生—肿瘤]