国际肿瘤学杂志

国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (11): 824-827.doi: 10.3760/cma.j.issn.1673422X.2015.11.007

• 论著 • 上一篇    下一篇

多层螺旋CT增强扫描对恶性肿瘤患者肾上腺腺瘤与转移瘤的鉴别诊断价值

史志勇,孙永,王娟,习顺国,王志国,苏铁涛   

  1. 050700 河北省新乐市中医医院放射科
  • 出版日期:2015-11-08 发布日期:2015-09-30
  • 通讯作者: 史志勇 E-mail:shizy740412@163.com

Differential diagnosis value of enhanced multislice spiral CT scan on adrenal adenoma from metastases in patients with malignant tumor

Shi Zhiyong, Sun Yong, Wang Juan, Xi Shunguo, Wang Zhiguo, Su Tietao.   

  1. Department of Radiology, Traditional Chinese Medicine Hospital of Xinle, Hebei Province, Xinle 050700, China
  • Online:2015-11-08 Published:2015-09-30
  • Contact: Shi Zhiyong E-mail:shizy740412@163.com

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被引次数

6

摘要： 目的探讨多层螺旋CT（MSCT）增强扫描在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39例患者共发现肾上腺结节49个，其中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呈轻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3 min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（t=4.006，P＜0.001）、平扫CT值（t=7.320，P＜0.001）、增强扫描动脉期CT值（t=2.486，P=0.017）、静脉期CT值（t=2.727，P=0.009）及延迟期CT值（t=6.653，P＜0.001）均高于肾上腺腺瘤，差异有统计学意义。结论MSCT增强扫描可反映肾上腺病变的血流动力学变化，为恶性肿瘤患者肾上腺转移瘤和腺瘤的鉴别诊断提供有力的依据。

关键词: 肿瘤, 肾上腺疾病, 腺瘤, 肿瘤转移

Abstract: ObjectiveTo evaluate the differential diagnosis value of enhanced multislice spiral CT (MSCT) scan on adrenal adenoma and metastases in patients with malignant tumor. MethodsThirtynine malignant tumor patients complicated with adrenal nodules were chosen, and all patients underwent MSCT plain scan and enhanced scan. Features of adrenal adenomas and metastases of MSCT enhanced were analyzed. ResultsFortynine adrenal gland nodules were found in 39 patients, and 35 adrenal metastasis were found in 25 patients. They were shown quasicircular, oval or irregular shaped nodules. The average diameter was (2.6±0.7)cm. Part of them were uneven density, and the CT value of the solid part was (32.8±6.1)Hu. The solid part of tumor in enhancement scanning arterial phase was underwent mild to moderate strengthening, and the CT value was (49.5±6.9)Hu. The solid part of tumor was underwent further strengthen scanning in the venous phase, and the CT value was (74.9±8.0)Hu. The average CT value of solid part in after 3 min scanning tumor was (72.4±7.6)Hu. Fourteen adrenal adenomas were found in 14 patients. CT value was (19.6±4.5)Hu, and tumor diameter was (1.8±0.4)cm. Enhanced scanning the tumors showed mild to moderate homogeneous enhancement in arterial phase, the CT value was (43.8±8.1)Hu. Venous phase enhanced obviously, the average of CT value was (67.7±9.2)Hu. The strong degree in the delay period was decreased significantly, the average value of CT was (55.9±8.8)Hu. The adrenal metastasis tumor diameter (t=4.006, P＜0.001), CT value of plain scan (t=7.320, P＜0.001), CT value of arterial phase enhanced scan (t=2.486, P=0.017), venous phase enhanced scan (t=2.727, P=0.009) and CT value of the delay period (t=6.653, P＜0.001) were higher than those in adrenal adenoma. ConclusionEnhanced MSCT scan can reflect the hemodynamic changes of adrenal lesions, and provide the bases for the differential diagnosis of enhanced MSCT scan on adrenal adenoma and metastases in patients with malignant tumor.

Key words: Neoplasms, Adrenal gland diseases, Adenoma, Neoplasm metastasis