摘要
目的分析肾上腺副节瘤及神经节瘤的影像特点,探讨两者表现的异同,提高对肾上腺疾病影像诊断的认识。方法收集手术病理证实的15例肾上腺副节瘤及13例肾上腺神经节瘤的CT、MRI资料,回顾性分析病灶的影像特点并与组织病理学特征相对照。结果所有病例均为单发病灶。副节瘤:右侧肾上腺病灶10例,左侧肾上腺病灶5例,病灶平均大小4.3 cm×5.2 cm,CT平扫肿瘤多数为低密度,少数可为等密度,肿瘤内发生出血、坏死和囊变而密度往往不均匀,1例肿瘤出现钙化,MR平扫为长T1长T2信号,增强后病灶强化明显,病灶内可出现纤维分隔,2例肿瘤为恶性病变,包绕并侵犯邻近的血管;神经节瘤:右侧肾上腺病灶7例,左侧肾上腺病灶6例,病灶平均大小3.5 cm×4.5 cm,CT平扫为低密度,MR平扫为长T1长T2信号,增强后早期轻度强化、延迟后进行性增强,肿瘤可有漩涡征及包绕血管,但不侵犯血管等征象,3例肿瘤内出现钙化。结论CT、MRI平扫及增强扫描能较好地显示肾上腺副节瘤、神经节瘤的内部结构和影像学特点,反映病灶的血供特点和病理特征,有助于两者及肾上腺其他病变的鉴别。
Objective To evaluate the image characteristics of adrenal paraganglioma and ganglioma and to improve the knowledge on the diagnosis of adrenal diseases. Methods CT,MRI data of 15 adrenal paraganglioma and 13 adrenal ganglioma confirmed by histopathology were reviewed. The image characteristics were analyzed retrospectively and correlated with histologic features. Results All cases appeared mono lesion. As for adrenal paraganglioma, 10 lesions occurred in the right adrenal gland, 5 in the left adrenal gland. The average diameter of the lesions was 4.3cm × 5.2cm. Most lesions appeared low attenuation in CT precontrast, minority appeared isodense, the density was usually heterogeneous because of hemorrhage, necrosis and cystic degeneration of the lesions. Punctate calcification was seen inside 1 tumor. Lesions were hypointense in T1WI and hyperintense in T2WI. After contrast administration, the lesions were enhanced markedly, some lesions showed fibrous septation. Two of the adrenal paraganglioma were malignant, surrounding and invading the neighbouring vessels. As for adrenal ganglioma, 7 in the right adrenal gland and 6 in the left. The average diameter of the lesions was 3.5 cm × 4.5 cm. CT precontrast appeared low intensity, signal characteristics were similar to that of adrenal paraganglioma in T1WI and T2WI. In contrast images, the tumors were early enhanced slightly and gradually enhanced on delayed phase. The whorled appearance was special to ganglioma, the lesions could surround the vessels but didn＇ t invade them. Punctate calcification was seen in 3 tumors. Conclusion Precontrast and contrast CT.MRI can disclose inner structure and image characteristics of adrenal paraganglioma and ganglioma, demonstrate the pathological features and blood supply of the lesions, therefore can contribute to the differentiation of the two tumors and other adrenal disease.
出处
《同济大学学报（医学版）》
CAS
2007年第5期78-82,86,共6页
Journal of Tongji University(Medical Science)
