肾上腺占位病变的CT、MRI诊断(附71例报告)  

CT and MRI Diagnosis of Adrenal Space-occupying Lesion: Reports of 71 Cases

作　　者：吉金钟 王勇 程敬亮[2] 李树新[2] 杨思福 钟涛 于红光 黄平波 魏民 

机构地区：[1]河南省中原油田总医院MR室,濮阳457001 [2]河南医科大学第一附属医院MR室,郑州450052 [3]河南省中原油田总医院病理科,濮阳457001

出　　处：《临床放射学杂志》2003年第B09期44-48,共5页Journal of Clinical Radiology

摘　　要：目的　探讨肾上腺占位病变的CT、MRI诊断价值 ,提高对肾上腺间质概念的认识。资料与方法　搜集1994年 8月～ 2 0 0 1年 6月经手术和病理证实的肾上腺占位病变 71例 ,4 6例行CT平扫 ,其中 31例进行增强扫描 ;30例行MRI平扫 ,18例行增强扫描 ;共有 5例行CT、MRI联合检查 (平扫 +增强 )。结果　 (1)皮质占位 36例 (占5 0 .7% ) ,其中醛固酮腺瘤 14例 ,皮质醇腺瘤 11例 ,无功能腺瘤 3例 ,皮质腺癌 2例 ,皮质增生症 6例 ;有 1例伴性变态综合征。 (2 )髓质占位 2 9例 (4 0 .8% ) ,其中嗜铬细胞瘤 16例 ,成神经细胞瘤 3例 ,节神经细胞瘤 2例 ,转移瘤 8例。 (3)间质占位 6例 (8.5 % ) ,其中髓样脂肪瘤 3例 ,囊肿 2例 ,纤维脂肪瘤 1例。结论　肾上腺占位病变多具有其特定的好发年龄、性别趋向及CT、MRI影像学特征 ,结合临床及实验室检查有助于提高占位病变诊断的准确性 ;但部分无功能腺瘤、转移瘤。Objective To study the value of CT and MRI in diagnosis of adrenal space occupying lesion and improve the knowledge for adrenal interstitial concept. Materials and Methods From August 1994 to June 2001,71 cases with confirmed adrenal space occupying lesions by surgery and pathology were collected. 46 cases were performed plain CT, and 31 of them added to enhanced CT. Other 30 cases underwent plain MRI and 18 of them added to enhanced MRI. The remaining 5 cases were scanned by CT and MRI. Results (1) Cortical space occupying lesion was seen in 36 cases (50.7%), including aldosterone adenoma in 14 cases, cortical adenoma in 11, non functional adenoma in 3, cortical adenocarcinoma in 2, cortical hyperplasia in 6. 1 of them had concomitant sexual perversion syndrome. (2)Medullary space occupying lesion was seen in 29 cases (40.8%), including pheochromocytoma in 16 cases, neuroblastoma in 3, ganglioma in 2 and metastasis in 8. (3)Interstitial space-occupying lesion was seen in 6 cases (8.5%), including myelolipema in 3 cases, cyst in 2 and fibrolipoma in 1. Conclusion Adrenal space occupying lesion has a preference for age, sex and characteristics of CT and MRI. Imaging features together with clinic and laboratory results are helpful to improving the accuracy for diagnosing space occupying lesion. Characterization of some of non functional adenomas, metastasizes and interstitial neoplasms, however, should be dependent on histopathology.

关 键 词：肾上腺占位病变 CT检查 MRI检查 诊断 影像学特征 

分 类 号：R445[医药卫生—影像医学与核医学]