ACTH非依赖性大结节样肾上腺增生的多层螺旋CT表现  

Multi-detector-row CT findings of ACTH-independent macronodular adrenal hyperplasia

作　　者：宋琦[1] 周薇薇[2] 苏颈为 杜联军[1] 丁蓓[1] 张欢[1] 潘自来[1] 陈克敏[1] 严福华[1] 王卫庆[2] 宁光[2] 方文强[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科 [2]内分泌代谢病科、上海市内分泌代谢病研究所、上海市内分泌代谢病临床医学中心

出　　处：《中华内分泌代谢杂志》2012年第4期335-339,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：上海市科技人才计划项目（10XD1403000）;上海市科委生物医药重点项目（09411954400、11411952000）

摘　　要：目的探讨ACTH非依赖性大结节样肾上腺增生（AIMAH）的多层螺旋CT特征性表现。方法回顾性分析24例（男性14例，女性10例）经临床证实的AIMAH患者的多层螺旋CT形态学表现和强化方式。结果24例患者均为双侧肾上腺受累（100％），双侧肾上腺明显增大，伴多个大小不等结节，结节大小约为0．50～3．85cm[平均（1．79±1．02）cm]，正常肾上腺组织被扭曲，结节之间的肾上腺肢体亦可明显增粗，增大的肾上腺保持原有的轮廓，呈特征性“生姜样”改变。22例（91．7％）增生的肾上腺呈均匀轻度强化。仅1例出现有钙化。结论多层螺旋CT能很好地显示肾上腺病灶的形态学改变和强化特点，同时结合临床表现和生化指标，可明显提高检出AIMAH的敏感性和准确性。Objective To explore the characteristics multi-detector-row computed tomography （MDCT） findings of ACTH-independent macronodular adrenal hyperplasia （AIMAH）. Methods The un-enhanced and contrast-enhanced MDCT features in 24 patients （ 14 males and 10 females） with clinically confirmed AIMAH were retrospectively assessed for the morphology and enhancement patterns. Results The adrenal glands were involved bilaterally in all of the 24 cases （ 100% ）. 24 patients had massively enlarged multinodular adrenal glands. Nodules were（ 1.79 ± 1.02 ） cm （ 0.50 - 3.85 cm）, which usually distorted and completely obscured the normal adrenal glands. The enlarged adrenal glands were still retained the adreniform contour, showed characteristic ＂gingerlike＂. 22 of the 24 （91.7%） hyperplastic nodular glands demonstrated mild homogeneous enhancement. Calcification was revealed in 1 adrenals （ 1/24, 4.2% ）. Conclusion MDCT reveals the characteristic morphology and CT attenuation in AIMAH. Combined with its clinical presentation and biochemical findings, AIMAH is able to be diagnosed with high specificity and accuracy on MDCT.

关 键 词：肾上腺 增生 促肾上腺皮质激素 体层摄影术 x线计算机 

分 类 号：R816.6[医药卫生—放射医学]