多层螺旋CT多期扫描鉴别多种肾上腺肿瘤的诊断价值  

The diagnostic value of multiphase MSCT scanning in the identification of adrenal tumors

作　　者：刘春艳[1] 兰国鹏 郑晓东 郑佳连[2] LIU Chun-yan;LAN Guo-peng;ZHENG Xiao-dong(Department of Image,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China;不详)

机构地区：[1]辽宁中医药大学附属医院影像科,辽宁沈阳110032 [2]辽宁中医药大学附属医院感染科,辽宁沈阳110032

出　　处：《中国医学装备》2021年第5期56-60,共5页China Medical Equipment

基　　金：辽宁省科学技术计划(2019-MS-231)“基于STING-IRF3信号转导通路从“气、血、湿”论治NASH的疗效机制研究”。

摘　　要：目的:分析多层螺旋CT(MSCT)多期扫描对肾上腺肿瘤的临床诊断价值。方法:选取医院收治的经病理检测证实且具有完整临床资料的61例肾上腺无功能肿瘤患者,共63个病灶。所有患者均行MSCT检查,分析肾上腺节细胞神经瘤(节细胞瘤)、无功能腺瘤(腺瘤)、无功能嗜络细胞瘤(嗜铬细胞瘤)和转移瘤病变患者临床病理检测情况,分析比较各类病变患者的MSCT表现及CT的特点。采用受试者工作特征(ROC)曲线分析MSCT多期扫描对肾上腺肿瘤的诊断价值。结果:4种类型的肾上腺病变在形态、密度及桃尖征、发病位置及病变性质的总体分布比较,差异均有统计学意义(χ^(2)=18.045,χ^(2)=34.731,χ^(2)=41.684,χ^(2)=16.899,χ^(2)=17.250;P<0.01)。节细胞瘤与腺瘤的形态比较,差异有统计学意义(χ^(2)=17.852,P<0.01);与嗜铬细胞瘤及转移瘤的密度比较,差异有统计学意义(χ^(2)=11.519,χ^(2)=9.385;P<0.01);与其他3种肿瘤的桃尖征比较,差异有统计学意义(χ^(2)=27.261,χ^(2)=15.362,χ^(2)=13.742;P<0.01)。节细胞瘤与腺瘤、嗜铬细胞瘤和转移瘤CT值在平扫、动脉期、静脉和延时的扫描方式下,差异均有统计学意义(F=78.840,F=880.830,F=517.280,F=187.250;P<0.01)。MSCT多期扫描诊断节细胞瘤、腺瘤、嗜络细胞瘤和转移瘤的ROC曲线下面积(AUC)分别为0.852、0.789、0.812和0.715。结论:肾上腺节细胞瘤的MSCT表现具有一定的特点,对其诊断及鉴别具有重要价值,可为临床诊断肾上腺节细胞瘤及鉴别肿瘤类型提供影像学依据。Objective:To analyze the clinically diagnostic value of multiphase multi-slice spiral computed tomography(MSCT)on adrenal tumors.Methods:61 cancer patients without adrenal functional who were confirmed by pathological examination and had complete clinical data were selected,and there were 63 lesions in them.All patients underwent MSCT examination,and the situations of clinically pathological examination of patients with adrenal ganglioma,nonfunctional adrenal adenoma(adenoma),nonfunctional pheochromocytoma(pheochromocytoma)and metastasis tumor lesion were analyzed.And the MSCT manifestation and CT characteristics of the patients with all kinds of lesions were analyzed and compared.The receiver operating characteristics(ROC)curve was adopted to analyze the diagnostic value of multiphase MSCT scan on adrenal tumor.Results:The differences of the population distributions of morphology,density,peach tip sign,lesion location and lesion nature of the four types of adrenal lesions were statistically significant(χ^(2)=18.045,χ^(2)=34.731,χ^(2)=41.684,χ^(2)=16.899,χ^(2)=17.250,P<0.01).The difference of morphology between ganglioma and adenoma was statistically significant(χ^(2)=17.852,P<0.01).The differences of the density between ganglioma and pheochromocytoma and between it and metastasis tumor were statistically significant(χ^(2)=11.519,χ^(2)=9.385,P<0.01),respectively.The differences of peach tip sign among it and other three kinds of tumors were statistically significant(χ^(2)=27.261,χ^(2)=15.362,χ^(2)=13.742,P<0.01).The differences of CT values under different scan methods included plain scan,arterial phase,vein and delayed scan between ganglioma and adenoma,and between ganglioma and pheochromocytoma,and between ganglioma and metastasis tumor were statistically significant(F=78.840,F=880.830,F=517.280,F=187.250,P<0.01).The area under curve(AUC)of ROC of multiphase MSCT in diagnosing ganglioma,adenoma,pheochromocytoma and metastasis tumor were 0.852,0.789,0.812 and 0.715,respectively.Conclusion:MSCT manifes

关 键 词：MSCT多期扫描 肾上腺肿瘤 诊断 鉴别 

分 类 号：R816.6[医药卫生—放射医学]