腹部异位嗜铬细胞瘤的CT特征及其诊断价值  

Diagnostic value of CT features of extra-adrenal pheochromocytoma

作　　者：王红月 周建平[2] 宋禾[2] 李新[2] WANG Hongyue;ZHOU Jianping;SONG He;LI Xin(Department of Pancreatic-biliary Surgery,The First Hospital of China Medical University,Shenyang 110001,China;Department of Gastrointestinal Surgery,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院胰胆外科,沈阳110001 [2]中国医科大学附属第一医院胃肠外科,沈阳110001

出　　处：《中国医科大学学报》2024年第8期697-703,共7页Journal of China Medical University

基　　金：辽宁省自然科学基金(2023-MS-170)。

摘　　要：目的分析腹部异位嗜铬细胞瘤的CT表现特征,探讨CT检查对异位嗜铬细胞瘤的诊断价值。方法回顾性收集经术后病理证实的83例腹部异位嗜铬细胞瘤患者的临床资料和CT影像学资料。所有患者均于术前行腹部CT检查,分析CT特异性表现,包括肿瘤部位、肿瘤数量、增强扫描强化程度、瘤体内有无囊变、是否浸润周围组织、肿瘤轴平面最大直径等。评估肿瘤大小与瘤体内囊变的关系,以及肿瘤CT特征与临床表现的关系。结果腹部异位嗜铬细胞瘤的典型CT表现为边界清楚、密度不均匀的圆形或椭圆形肿块,边缘实质区强化,多有中心低密度坏死区不强化,多位于腹部大血管旁。瘤体内囊变的发生与肿瘤大小相关(P=0.001)。腹部不适、高血压病史等临床表现与肿瘤部位、是否囊变无明显相关性(P>0.05),术中剧烈的血压波动与肿瘤部位相关(P=0.020)。瘤体较大的患者更易出现腹部不适症状(P=0.032),且更多合并高血压病史(P=0.043)。结论CT是异位嗜铬细胞瘤定位、定性诊断的重要影像学检查方法,可清楚地显示肿瘤的部位、形态特征、大小及其与周围结构的关系,能够提高临床诊断率。Objective To explore the computed tomography(CT)-specific imaging findings of extra-adrenal pheochromocytoma and their diagnostic value.Methods We retrospectively analyzed the clinical records of 83 patients with extra-adrenal pheochromocytoma.All patients underwent preoperative abdominal CT.We then assessed the relationship between tumor size and tumor cystic changes and between tumor CT features and clinical manifestations.Results The typical CT image of extra-adrenal pheochromocytoma is a round or oval mass with photoplastic margins and uneven density,enhanced marginal high-density areas with mostly central low-density necrotic areas,and a location beside large abdominal vessels.The occurrence of cystic changes in the tumor was significantly correlated with a large tumor size(P=0.001).Clinical manifestations such as abdominal discomfort and a history of hypertension were not significantly associated with tumor location or cystic changes(P>0.05).Severe intraoperative blood pressure fluctuations were associated with tumor location(P=0.020).Patients with larger tumors were more likely to have abdominal discomfort(P=0.032)and a history of hypertension(P=0.043).Conclusion CT is an important imaging modality for the localization and qualitative diagnosis of extra-adrenal pheochromocytomas and can improve the clinical diagnosis rate.

关 键 词：异位嗜铬细胞瘤 CT特征 诊断 临床表现 

分 类 号：R736.6[医药卫生—肿瘤]