摘要
目的探讨多层螺旋CT(MSCT)增强扫描在恶性肿瘤患者肾上腺腺瘤和转移瘤鉴别诊断中的价值。方法选择39例恶性肿瘤并发肾上腺结节患者,对所有患者均采用MSCT平扫和增强扫描,分析恶性肿瘤患者肾上腺腺瘤和转移瘤的MSCT增强特点。结果 25例患者共有肾上腺转移瘤35个,表现为类圆形、椭圆形或不规则形结节影,平均直径为(2.6±0.7)cm,部分密度不均,实性部分CT值为(32.8±6.1)Hu,增强扫描动脉期肿瘤实性部分轻-中度强化,CT值为(49.5±6.9)Hu,静脉期扫描肿瘤实性部分进一步强化,CT值为(74.9±8.0)Hu,延时3min扫描肿瘤实性部分CT值平均为(72.4±7.6)Hu。14例患者发现肾上腺腺瘤14个,CT值为(19.6±4.5)Hu,肿瘤直径为(1.8±0.4)cm,增强扫描动脉期肿瘤呈轻中度均匀强化,CT值为(43.8±8.1)Hu,静脉期强化明显,CT值平均为(67.7±9.2)Hu,延迟期强化程度明显下降,CT值平均为(55.9±8.8)Hu。肾上腺转移瘤直径、平扫CT值及增强扫描各期CT值均高于肾上腺腺瘤(P<0.05)。结论 MSCT增强扫描可反映肾上腺病变的血流动力学变化,为肾上腺转移瘤和腺瘤的鉴别诊断提供有力的依据。
Objective To evaluate the value of enhanced multislice spiral CT（MSCT）scan in differential diagnosis ofadrenal adenoma and metastases in patients with malignant tumor. Methods MSCT plain scan and enhanced scan wereperformed in 39 malignant tumor patients complicated with adrenal nodules and features of adrenal adenomas and metastasesshown by MSCT were analyzed. Results Totally 35 metastatic adrenal adenomas were detected in all 25 patients,exhibitingquasi-circular,oval or irregular shaped nodules with average diameter of（2.6±0.7）cm and the density of some tumors wasuneven,the CT value of the solid part was（32.8±6.1）Hu;The CT value in the solid part of tumor underwent mild to moderateenhancement scanning in arterial phase were（49.5±6.9）Hu,and that in the solid part of tumor underwent further enhancedscanning in the venous phase was（74.9±8.0）Hu,the average CT value of solid part in tumor after longer scanning of threeminutes was（72.4±7.6）Hu. Adrenal adenomas were detected in 14 patients with the CT value of（19.6±4.5）Hu and thetumor diameter of（1.8±0.4）cm. The CT value in tumors underwent mild to moderate enhanced scanning in arterial phase was（43.8±8.1）Hu,and that underwent remarkable enhanced scanning in venous phase was（67.7±9.2）Hu,and that in delayperiod significantly decreased to（55.9±8.8）Hu. The diameter,CT value of plain scan and enhanced scan metastatic adrenaladenomas were higher than those of adrenal adenoma（P〈0.05）. Conclusion Enhanced MSCT scan can reflect thehemodynamic changes in adrenal lesions and provide the basis for the differential diagnosis of metastatic adrenal adenoma fromadrenal adenoma in malignant tumor patients.
出处
《中国热带医学》
CAS
2015年第7期890-892,共3页
China Tropical Medicine
关键词
恶性肿瘤
肾上腺病变
腺瘤
转移瘤
Malignant tumors
Aadrenal lesion
Adenoma
Metastatic tumor
