肾上腺皮质腺癌CT影像诊断  

Imaging Features of Computed Tomography of Adrenocortical Adenocarcinoma

作　　者：范小晶[1] 潘卫东[1] 梁继祥[1] 秦明伟 

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院放射科,北京市100730 [2]中国医学科学院,北京协和医学院,北京协和医院保健医疗部,北京市100730

出　　处：《中华全科医学》2012年第12期1946-1948,共3页Chinese Journal of General Practice

摘　　要：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 evaluate the imaging features of computed tomography （CT） diagnosis of adrenocortical adenocarci- noma. Methods CT images of 21 patients who were pathologically diagnosed as adrenocortical cancer（ACC） between Jan,2005 and Sep,2011 in Peking Union Medical College Hospital were retrospectively evaluated. Results There were 14 cases of func- tional and 7 cases of non-functional ACC. The tumors in all 21 cases were unilateral ,the diameters were equal or more than 6 cm, the appearance of ACC on CT is inhomogeneous. 20 cases were with intratumoral hemorrhagic necrosis ,5 cases with calcification and solid portion showed heterogeneous enhancement. 9 cases were with invasion into adjacent tissues and 11 cases with metasta- ses. 18 cases were preoperative accurate diagnosed as ACC and 3 eases were misdiagnosed with pheoehromocytoma, the overall co- incidence rates for the pathological diagnosis were 85.7%. Conclusion CT imaging is an important mean to detect ACC. By an- alyzing the characteristics of CT imaging and clinical and laboratory examination, the accurate diagnosis can be obtained. But in some cases, ACC needed to be differentiated with pheochromocytoma, the final confirmation depends on pathology.

关 键 词：肾上腺皮质腺癌 体层摄影 X线计算机 廓清率 

分 类 号：R736.6[医药卫生—肿瘤] R814.42[医药卫生—临床医学]