原发性肾上腺皮质腺癌的CT表现与病理特点  

CT Manifestations and Pathological Features of Primary Adrenocortical Carcinoma

作　　者：许晓琴[1] 姚振威 林含舜 尹冬青[3] 林斌 XU Xiao-qin;YAO Zhen-wei;LIN Han-shun;YIN Dong-qing;LIN Bin(Department of Radiology, Taizhou Municipal Hospital;Department of Radiology, Huashan Hospital, Fudan University;Department of Pathology, Taizhou Municipal Hospital;Department of Radiology, The Second Affiliated Hospital College of MedicineZhejiang University)

机构地区：[1]浙江省台州市立医院影像科 [2]复旦大学附属华山医院放射科 [3]浙江省台州市立医院病理科 [4]浙江大学医学院附属第二医院放射科

出　　处：《中国医学计算机成像杂志》2019年第1期37-41,共5页Chinese Computed Medical Imaging

摘　　要：目的:分析原发性肾上腺皮质腺癌(ACC)的CT表现与病理特点,以提高诊断的准确性。方法:回顾性分析经手术与病理证实的16例ACC的CT图像特点、临床资料及病理学特点。结果:功能性ACC6例,无功能性ACC 10例;16例ACC中,位于左侧肾上腺7例,右侧9例,大小4.4cm×5.4cm～14cm×17cm,最小直径<5cm3例;CT平扫表现为分叶状或不规则7例,类圆形3例,椭圆形6例;边界模糊9例,边界较清7例;内见点状或条状钙化5例;病灶内坏死形态不规则15例。16例ACC增强后全部表现为不均匀强化,坏死边缘显示较模糊。其中6例ACC中央出现星芒状、裂隙状较宽区域坏死;2例肿瘤实质大部分坏死形成假囊肿样。病理上肿瘤血管丰富,多见广泛出血、坏死,有血管包膜浸润。结论:ACC的CT表现具有一定的特征性,与其病理改变有一定的关系。掌握这些有助于提高诊断正确率。Purpose: To analyze the CT characteristics and pathological features of primary adrenocortical carcinoma(ACC), to improve the diagnostic accuracy of it.Methods: The CT manifestations, clinical information and pathological features of 16 ACC cases proved by surgery and pathology results were analyzed retrospectively.Results: There were 6 functional tumors and 10 non-functional masses. Seven of 16 lesions were located in the left adrenal gland, 9 in the right. The size of the tumors was ranged 4.4 cm×5.4 cm-14 cm×17 cm, 3 lesions were with diameter less than 5.0 cm. On plain CT: 7 lesions were lobulated or irregular, 3 lesions were round, 6 lesions were oval-shaped;9 lesions were ill-defined and 7 cases were well defined;5 lesions showed with spot or strip-like calcification;15 cases were with necrosis;All 16 cases were inhomogeneous enhanced after contrast administration,and 2 cases with necrosis showed pseudocyst-like feature. The pathological result showed that all tumors were with illustrated confluent blood vessels, with hemorrhage and necrosis. The membrane of the vessels were infiltrated.Conclusion: The CT manifestations of adrenocortical carcinoma are characteristic, they have certain relationship with the pathological changes. Familiar with these will improve their diagnostic accuracy.

关 键 词：肾上腺皮质腺癌 体层摄影 X线计算机 病理 

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