多层螺旋CT对肾上腺结核的诊断价值  

Diagnostic Value of Multislice Spiral CT in Adrenal Tuberculosis

作　　者：全昌斌[1] 袁小东[1] 时文伟 董莘[1] 敖国昆[1] 李红[1] 

机构地区：[1]解放军第三零九医院放射科,北京100091

出　　处：《临床放射学杂志》2015年第8期1242-1246,共5页Journal of Clinical Radiology

摘　　要：目的探讨多层螺旋CT扫描在肾上腺结核诊治中的应用价值,以提高该病的影像诊断水平。方法回顾性分析经临床确诊的35例肾上腺结核患者的CT表现及临床资料,其中31例有明确的其他部位活动性结核或结核病史。35例均行CT平扫,26例加做CT增强扫描。结果 35病例中,双侧受累28例（80%）,单侧受累7例（20%）。病变形态呈普大型17例,结节型4例,肿块型14例。病灶直径5~86 mm不等。病灶边缘模糊者25例（71.4%）,边缘清晰者10例（28.6%）。病灶中有钙化密度者21例（60%）,无钙化密度者14例（40%）。35例中26例行增强扫描,病灶呈周边环形强化14例（53.8%）,不均匀轻度强化5例（19.2%）,无强化7例（26.9%）。CT误诊6例,其中误诊为肾上腺腺瘤3例,误诊为肾上腺增生2例,误诊为转移瘤1例。35例CT扫描图像所及范围有20例同时显示合并有其他部位结核。10例在抗结核治疗后行CT扫描复查：6例病灶有好转缩小,其中有2例新出现钙化灶;3例无变化;1例病灶增多增大。结论肾上腺结核的MSCT表现具有一定的特征性,且与临床病程存在较明显的相关性,对该病的诊断及治疗均具有重要的应用价值。Objective To investigate the diagnostic value of multi-slice spiral CT in adrenal tuberculosis. Methods A retrospective analysis of CT findings and clinical data of 35 cases of adrenal tuberculosis was performed,including 31 cases with clear active tuberculosis. All cases underwent CT examination,among which 26 cases underwent enhanced CT scan. Results Of all cases,28 cases（ 80. 0%） with bilateral involvement,7 with unilateral involvement,17 cases with enlargement,4cases with nodulesand 14 with mass lesion. Lesion diameter ranging from 5 to 86 mm. 25 cases with blur edge（ 71. 4%）,10 cases（ 28. 6%） with sharp edge,21 cases（ 60. 0%） with calcification,14 cases（ 40. 0%） without calcification. Of the 26 enhancement cases,14 cases（ 53. 8%） showed peripheral ring enhancement,5 cases（ 19. 2%）showed mild heterogeneous enhancement,and 7 cases（ 26. 9%） had no enhancement. 6 cases were misdiagnosed; 3 as adrenal adenoma,2 adrenal hyperplasia,and 1 metastases. Conclusion MSCT findings of adrenal tuberculosis have certain characteristics,and closely correlated with its clinical course,therefore are of important value for its management.

关 键 词：肾上腺 结核 体层摄影术 X线计算机 

分 类 号：R529.0[医药卫生—内科学] R816.6[医药卫生—临床医学]