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作 者:王越 张升华 黄勇 李万湖 戚元刚 王金之 WANG Yue;ZHANG Shenghua;HUANG Yong(Department of Radiology,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan,Shandong Province 250117,P.R.China)
机构地区:[1]山东省肿瘤防治研究院(山东省肿瘤医院),山东第一医科大学(山东省医学科学院)影像科,济南250117 [2]山东省肿瘤防治研究院(山东省肿瘤医院),山东第一医科大学(山东省医学科学院)胸部放疗一病区,济南250117
出 处:《临床放射学杂志》2022年第3期525-528,共4页Journal of Clinical Radiology
基 金:山东省自然科学基金资助项目(编号:ZR2019PH115);山东省医药卫生科技发展计划项目(编号:2019WS200)。
摘 要:目的提高对肾上腺囊肿的认识及影像诊断水平。方法对术前误诊、术后经病理证实的13例肾上腺囊肿患者的CT影像资料进行回顾性分析,总结误诊原因。结果7例术前CT误诊为肾上腺腺瘤,直径均<3.0 cm,呈圆形或椭圆形均匀低密度灶,边缘光滑,囊壁显示不清,其中1例病灶边缘伴点状钙化;病理显示假性囊肿、内皮性囊肿和上皮性囊肿各2例、单纯性囊肿1例。3例误诊为肝或肾囊肿,直径均>8.0 cm且压迫肝或肾形成深大压迹;病理显示假性囊肿1例、单纯性囊肿2例。3例误诊为其他类别的肾上腺肿瘤,均表现为厚壁囊肿,其中2例病灶囊壁伴“蛋壳”样或不规则形钙化,囊内密度均匀或不均;病理均为假性囊肿。结论肾上腺病变过小导致细节显示欠佳,过大挤压邻近肝肾以及合并钙化、感染及出血等并发症是导致肾上腺囊肿误诊的常见原因,影像诊断应提高警惕。Objective To improve the recognition and imaging diagnosis of adrenal cyst on CT.Methods The CT images of 13 patients with adrenal cyst which were misdiagnosed preoperatively and confirmed by postoperative pathology were analyzed retrospectively to sum up the reasons of misdiagnosis.Results 7 cases were misdiagnosed as adrenal adenoma,which were less than 3.0 cm in diameter,round or elliptical homogeneous low-density lesions with smooth edge and unclear cystic wall.One of them was accompanied by punctate calcification at the edge of the lesion.Pathology confirmed 2 cases of pseudocyst,2 endothelial cyst,2 epithelial cyst and 1 simple cyst.3 cases were misdiagnosed as hepatic cyst or renal cyst.All of them were larger than 8.0 cm in diameter and formed deep indentation on the liver or kidney.Pathology confirmed 2 cases of simple cyst and 1 case of pseudocyst.3 cases were misdiagnosed as other types of adrenal tumors.They showed thick-walled cyst with uniform or uneven density in the cyst,of which 2 cases had eggshell-like or irregular calcification.All cases were proved as pseudocyst pathologically.Conclusion Minor adrenal lesions resulting in poor details,giant lesions compressing the adjacent liver and kidney and complications(such as calcification,infection,and bleeding)were the common reasons for misdiagnosis of adrenal cyst,which should be vigilant in diagnosis.
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