原发性肾上腺皮质癌的临床特征及CT、MRI影像学表现  

Clinical Features and CT/MRI Imaging of Primary Adrenocortical Carcinoma

作　　者：王颖奕 梁辰 孙涛 周春宇 WANG Ying-yi;LIANG Chen;SUN Tao;ZHOU Chun-yu(Department of Radiology,the Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院放射科,重庆400037

出　　处：《中国CT和MRI杂志》2024年第12期128-131,共4页Chinese Journal of CT and MRI

基　　金：重庆市自然科学基金面上项目(CSTB2022NSCQ-MSX0763,2022-08-01—2025-07-31)。

摘　　要：目的探讨原发性肾上腺皮质癌(ACC)的临床特征及CT、MRI影像学表现。方法回顾性分析经手术病理证实的14例ACC患者的临床资料及影像学表现,CT/MRI平扫加增强分别12例、5例。结果14例肿瘤均单发(右侧4例、左侧10例);男:女=5:2,年龄13岁~73岁,吸烟5例,面部及双下肢水肿2例,腹胀、腹痛或腰痛7例,头晕伴全身乏力1例,闭经1例,体检偶然发现3例。肿瘤最大径范围8.2~20.8cm,形态不规则12例,边界不清7例。CT(12例):瘤内囊变坏死12例、钙化8例、出血4例,肾周筋膜增厚8例,实性部分平扫CT值为(38.7±6.7)Hu。CT增强扫描动脉期实性部分内见粗大肿瘤血管影,静脉期进一步强化、强化范围稍扩大,延迟期强化程度稍减弱;肿瘤中心囊变坏死区未见确切强化。MRI(5例):T1WI呈稍低信号影为主,T2WI呈混杂稍高信号影为主,DWI弥散受限1例,瘤内囊变坏死5例、出血5例(其中伴含铁血黄素沉积1例)、瘢痕组织2例、脂质成分1例,增强扫描强化方式与CT相似。肿瘤边缘线样包膜结构延迟强化7例。14例肿瘤伴左肾静脉癌栓者3例,伴肝脏转移者1例。结论ACC的临床症状无特异性,ACC有一定的影像学特征,CT、MRI检查在ACC的诊断中各具优势,联合应用对ACC的诊断及鉴别诊断具有重要意义。Objective To investigate the clinical features and CT/MRI imaging findings of primary adrenocortical carcinoma(ACC).MethodsThe clinical datas and imaging findings of 14 patients with ACC who confirmed by surgical pathology were retrospectively analyzed,12 patients and 5 patients underwent CT and MRI plain scan with enhanced imaging,respectively.ResultsAll 14 patients had solitary tumor(there were 4 cases on the right and 10 cases on the left);male:female=5:2,aged from 13 to 73 years old,5 cases were smoking,2 cases had oedema in the face and both lower limbs,7 cases were distension,abdominal pain or low back pain,1 case was dizziness with general fatigue,1 case was amenorrhea,3 cases were accidentally found by physical examination.The maximum diameter of the tumor ranged from 8.2 to 20.8 cm,among them 12 cases had irregular morphology,and 7 cases had unclear boundaries.CT(12 cases):Among 12 patients,there were 12 patients with cystic degeneration and necrosis,8 patients with calcification,and 4 patients with hemorrhage in the tumor,8 patients with thickened perirenal fascia,and the plain CT value of the solid part was(38.7±6.7)Hu.CT enhanced scan showed a larger vascular shadow in the solid part of the arterial stage,the venous stage was further enhanced than the arterial stage,the scope of enhancement was slightly expanded,and the enhancement was slightly weakened in the delayed stage;no definite enhancement was found in the cystic necrosis area in the center of the tumor.MRI(5 cases):T1WI mainly showed slightly low signal,T2WI showed mixed slightly high signal mainly,1 case of DWI had limited diffusion,there were 5 cases with intratumoral cystic necrosis and hemorrhage(including hemosiderin deposition 1 case),2 cases of scar tissue,and 1 case of lipid components.The enhancement method of enhanced scanning was similar to that of CT.There were 7 cases of delayed enhancement of tumor margin line-like capsular structure.Among the 14 patients with ACC,3 cases were associated with left renal vein tumor thrombus,and

关 键 词：肾上腺皮质癌 CT MRI 增强扫描 临床特征 

分 类 号：R586[医药卫生—内分泌]