肾上腺皮质肿瘤患者超声征象与临床病理学类型的相关性分析  

Correlation of ultrasound findings with clinical pathological types of adrenal cortical tumors

作　　者：张毅[1] 王新生[2] 袁梅[1] 孙立江[2] 王伟[3] 周亚丽[1] 李文晓[1] 

机构地区：[1]青岛大学附属医院健康管理中心超声科,266003 [2]青岛大学附属医院健康管理中心泌尿外科,266003 [3]青岛大学附属医院健康管理中心病理科,266003

出　　处：《中华全科医师杂志》2018年第3期192-196,共5页Chinese Journal of General Practitioners

摘　　要：目的探讨肾上腺皮质肿瘤（ACT）的超声征象与临床病理学类型的相关性。方法回顾性分析2006年1月至2015年12月在青岛大学附属医院经超声检查、手术治疗和病理检查诊断为ACT患者138例的临床资料。采用Spearman法分析ACT的超声征象与临床病理学类型的相关性。结果138例中，男65例，女73例。年龄18～71岁。90例患者分别表现为高血压、Cushing征、Coon征、性征异常等，临床诊断为肾上腺皮质增生或腺瘤；48例无任何症状者由超声检查首先发现。超声定位与手术定位诊断符合率为94.2%（130/138），超声定位错误8例。超声定性与临床病理学诊断符合率为92.0%（127/138），错诊11例；各类肿瘤诊断符合率：无功能皮质腺瘤95.8%（46/48），皮质醇皮质腺瘤94.1%（32/34），醛固酮皮质腺瘤93.6%（29/31），皮质囊肿9/10，无功能腺癌5/6，性征异常皮质腺癌3/4，皮质醇皮质腺癌2/3，黏液样皮质腺瘤1/2。ACT直径0.6 ～11.5 cm。超声征象：肾上腺区类圆形低回声结节，直径〈2.0 cm与醛固酮皮质腺瘤相关（r＝0.485，P＝0.01）；低回声或等回声结节，直径2.0～5.0 cm与皮质醇皮质腺瘤、无功能皮质腺瘤相关（r＝0.567，0.452, P＝0.01），类圆形无回声结节与皮质囊肿相关（r＝0.483，P＝0.01）；结节形态不规则，直径≥5.0 cm与皮质腺癌相关（r＝0.595，P＝0.01）。结论ACT的超声征象与不同的临床病理学类型有关，可为临床诊断和选择术式提供参考。Objective To investigate the correlation between ultrasound findings and clinical pathological types of adrenal cortical tumors （ ACT ）. Methods The clinical data and uhrasonographic finding of 138 ACT patients undergoing surgical treatment in Affiliated Hospital of Qingdao University from January 2006 to December 2015 were retrospectively reviewed. The correlation between ultrasonic signs and pathological types of ACT was analyzed with Spearman method. Results There were 65 males and 73 females aged 18 -71 years old. Among 138 cases, 90 patients were characterized by hypertension, Cushing signs, Coon signs and abnormal sexual character, with the clinical diagnosis of adrenal cortical hyperplasia or adenoma; while 48 asymptomatic patients were first detected by uhrasonography. The coincidence rate of ultrasound and clinical pathological diagnosis was 92.0% （ 127/138 ） , and 11 cases were misdiagnosed. The coincidence rate of ultrasound and surgical diagnosis was 94.2% （130/138）, and 8 cases were misdiagnosed. The coincidence rate for no functional adenoma was 95.8% （46/48） , for cortisol cortical adenoma was 94. 1% （32/34） , for aldosterone cortical adenoma was 93.6% （29/31 ）, for cortical cysts was 9/10, for no functional adenocarcinoma was 5/6, for sexual abnormal cortical adenocarcinoma was 3/4, for cortisol cortical adenocarcinoma was 2/3, for mucous cortical adenoma was 1/2. The diameter of ACT was 0.6 - 11. 5 cm. The low echo nodules of the adrenal region with a diameter 〈 2.0 cm were associated with aldosterone cortical adenomas （r = 0. 485, P = 0.01 ） ; the low echo or isoechoic nodules with a diameter 2. 0 - 5.0 cm were associated with cortical adenomas or non-functional adenomas （ r = 0. 567, 0. 452, P = 0.01 ） , and the circular non-echo nodules were associated with cortical cysts （ r = 0. 483, P = 0.01 ） ; the irregular nodules with a diameter 〉 5.0 cm were associated with cortical adenocarcinoma （ r = 0. 595, P = 0.01 ）. Conclusion The ultrasound image of A

关 键 词：肾上腺皮质肿瘤 超声检查 病理学 临床 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.6[医药卫生—诊断学]