肾上腺髓样脂肪瘤与肾上腺皮质腺瘤的影像学诊断比较  

Comparison of imaging diagnosis between adrenal myelolipoma and adrenal cortical adenoma

作　　者：吴明[1] 张欣玉 石锋[1] 舒松[1] WU Ming;ZHANG Xinyu;SHI Feng;SHU Song(Department of Radiology,the First People's Hospital of Tianmen City,Hubei Province,Tianmen,Hubei,431700,China)

机构地区：[1]湖北省天门市第一人民医院放射科,湖北天门431700

出　　处：《当代医学》2021年第5期37-39,共3页Contemporary Medicine

摘　　要：目的分析CT诊断肾上腺髓样脂肪瘤(AML)与肾上腺皮质腺瘤(ACA)的特点及鉴别价值。方法选取本院2017年1月至2018年12月收治的AML患者23例为观察组,另选同期ACA患者23例为对照组,所有患者均行CT检查,分析两组CT诊断情况。结果观察组患者均为单发病灶,病灶多数边缘清晰,形状规则似椭圆形,密度不均匀,CT值-66~-118 HU,86.96%病灶以脂肪为主,病灶内可见斑片状稍高密度影及条状分隔,增强扫描显示脂肪区域无强化,实性部分及分隔轻度强化。对照组患者均为单发病灶,病灶多数边缘清晰、形态规则,为类圆形,密度均匀,CT值-19~25 HU,增强扫描显示病灶呈轻中度强化。观察组病灶平均长径、平均宽径均长于对照组(P<0.05);观察组平扫CT值、强化动脉期CT值及强化静脉期CT值均低于对照组(P<0.05);长径、平扫CT值、强化动脉期CT值、强化静脉期CT值ROC曲线下面积分别为0.899、0.822、0.918、0.949(P<0.05)。结论肾上腺髓样脂肪瘤与肾上腺皮质腺瘤CT检查中病灶大小、强化、密度、CT值均有特异性,可作为诊断及鉴别诊断肾上腺髓样脂肪瘤与肾上腺皮质腺瘤的辅助手段。Objective To analyze the characteristics and differential value of CT diagnosis of adrenal myeloid lipoma(AML)and adrenal cortical adenoma(ACA).Methods 23 patients with AML from January 2017 to December 2018 were enrolled in the observation group.Another 23 patients with ACA were enrolled in the control group.All patients underwent CT examination.The CT diagnosis of the two groups was retrospectively analyzed.Results The patients in observation group were single lesions,most of the lesions were clear,the shape was irregular,and the density was uneven.The density ranged from-66 to-118 HU.86.96%of the lesions were mainly fat,and CT showed patch.The lesions showed patchy slightly high-density shadows and strips.The enhanced scan showed no enhancement of the fat area,and the solid part and the partition were slightly enhanced.The patients in control group were single lesions.Most of the lesions had clear margins and regular morphology.They were round with uniform density.They showed density values ranging from-19 to 25 HU.Enhanced scan showed mild to moderate enhancement of lesions.The mean long diameter and mean width of the lesions in the observation group were longer than those in the control group(P<0.05);observation group plain CT value,enhanced arterial phase CT value and enhanced venous phase CT value were lower than ACA group(P<0.05);long diameter,plain CT value,enhanced arterial phase CT value,enhanced venous phase CT The area under the ROC curve was 0.899,0.822,0.918,and 0.949(P<0.05).Conclusion The lesion size,enhancement,density and CT value of adrenal myeloid lipoma and adrenal cortical adenoma are specific,which can be used as an auxiliary means for diagnosis and differential diagnosis of adrenal myelolipoma and adrenal cortical adenoma.

关 键 词：肾上腺髓样脂肪瘤 肾上腺皮质腺瘤 CT 鉴别诊断 ROC 

分 类 号：R736.6[医药卫生—肿瘤]