不典型肾上腺腺瘤的CT影像误诊分析  

Analysis of atypical CT imaging misdiagnosis of adrenal adenoma

作　　者：李盛[1] 陈锋[1] 兰朋训 

机构地区：[1]宁波大学医学院附属鄞州医院放射科,浙江宁波315040

出　　处：《医学影像学杂志》2014年第4期553-556,共4页Journal of Medical Imaging

摘　　要：目的通过回顾性分析11例不典型肾上腺腺瘤的CT影像特征及误诊原因,以提高诊断准确率。方法收集近几年经手术病理确诊的不典型肾上腺腺瘤11例,均行CT平扫及三期增强扫描,结合临床资料进行回顾性分析。结果11例肾上腺腺瘤中,高强化腺瘤2例,肿块最大径>4cm的大腺瘤8例,双侧腺瘤1例。高强化腺瘤在CT增强表现为快进快退;大腺瘤中囊性密度和强化较低的2例,肿瘤内出血的无功能肾上腺瘤1例,CT增强表现为快进快退伴偏心囊变的5例,双侧高强化的肾上腺腺瘤1例。结论详细分析不典型肾上腺腺瘤的CT特征,密切联系临床病史、实验室结果和MRI检查,可提高不典型肾上腺腺瘤的诊断准确率。Objective By reviewing the CT imaging features of atypical adrenal adenoma ,we analyzed the reason of mis-diagnosis so as to improve the diagnostic accuracy rate .Methods 11 cases of atypical adrenal adenomas with the clinical data ,pathological data were collected in our hospital in recent years .All patients underwent CT plain and three phase en-hanced scanning and combined with the clinic ,data were retrospectively analyzed .Results 2 cases of the high enhanced adrenal adenoma ,8 cases of the largest tumor diameter 〉4 cm large adenoma and 1 case of bilateral high strengthening ad-enoma were seen in 11 cases of adrenal adenoma .The enhanced CT performance of fast forward and rewind was found in high enhanced adrenal adenoma .2 cases of cystic density and low enhanced and 1 case of intratumoral hemorrhage of non functional big adrenal adenoma were seen in large adenoma cases .5 cases were manifested as CT enhanced findings of fast forward and rewind with eccentric cystic degeneration .Bilateral high strengthening adrenal adenoma was shown in 1 case . Conclusion Careful analysis of CT images in atypical adrenal adenoma ,combining with clinical history ,laboratory exami-nation and M RI scan ,can improve diagnostic rate of atypical adrenal adenoma .

关 键 词：不典型肾上腺腺瘤 体层摄影术 X线计算机 误诊分析 

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