摘要
目的探讨肾上腺皮质腺瘤、嗜铬细胞瘤CT影像与相关生化指标的特点及相关性。方法回顾性收集209例肾上腺良性肿瘤CT表现与皮质醇节律、高血压卧立位试验及24 h尿甲氧基两项等数据,对比分析各良性肿瘤CT影像与生化指标之间的关系。结果 53例皮质醇腺瘤、65例醛固酮腺瘤、45例无功能腺瘤及46例嗜铬细胞瘤的平扫CT值分别为17.25±1.81,14.52±1.57,12.20±2.05,42.42±0.97 HU;增强CT值(动脉期)分别为47.82±3.07,39.23±2.37,45.35±6.46,104.93±5.84 HU;差值(增强CT值-平扫CT值)分别为30.58±2.29,24.71±1.55,33.15±5.18,62.51±5.73 HU;皮质醇腺瘤组患者自变量平扫CT值分别与16点、24点皮质醇水平呈正相关;增强CT值分别与16点、24点皮质醇水平呈正相关;嗜铬细胞瘤组患者,自变量增强CT值及差值与24 h尿甲氧基肾上腺素、去甲肾上腺素之间均呈相关。其余各组常见良性肿瘤CT值和生化指标相关性分析未发现统计学意义。结论 CT值在肾上腺腺瘤与嗜铬细胞瘤的鉴别诊断上有重要价值,结合生化指标能减少嗜铬细胞瘤的误诊和漏诊。
Objective To investigate the correlation between CT image presentations and biochemical indexes in adrenal adenomas and pheochromocytomas. Methods We retrospectively analyzed the CT features, cortisol rhythm, supine and orthostatic hypertension and 24- h urine methoxy in 209 patients with benign adrenal tumors. The relationship between CT findings and the biochemical indexes were analyzed in patients with different benign adrenal tumors. Results The 209 cases analyzed included 53 cases of cortisol adenoma, 65 cases of aldosterone adenoma, 45 cases of non-functional adenoma and 46 cases of pheochromocytomas. The plain CT scan values of the 4 groups were 17.25±1.81, 14.52±1.57, 12.20±2.05, 42.42±0.97 HU,enhanced CT values（arterial phase） were 47.82 ± 3.07, 39.23 ± 2.37, 45.35 ± 6.46, and 104.93 ± 5.84 HU, respectively, and the differences between CT scan and enhanced CT values were 30.58±2.29, 24.71±1.55, 33.15±5.18, and 62.51±5.73 HU, respectively.In cortisol adenoma group, cortisol levels measured at 16：00 and 24：00 were positively correlated with plain CT scan value（r=0.506, P=0.0001; r=0.504, P=0.0001） and enhanced CT value（r=0.514, P=0.0001; r=0.554, P=0.0001）. In pheochromocytoma group,plain scan CT value and the difference between plain and enhanced CT scan value were correlated with 24-h urine methoxy adrenaline（ρ =0.342, 0.350; P=0.020, 0.017, respectively） and norepinephrine（ρ =0.419, 0.412; P=0.004, 0.004, respectively）.Conclusion Plain and enhanced CT scan values and their combination have important value in differential diagnosis of adenoma and pheochromocytoma tumor, CT values combine with biochemical indexes can reduce misdiagnosis and missed diagnosis of pheochromocytoma.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2015年第12期1792-1796,共5页
Journal of Southern Medical University
