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目的探讨不同病理类型肾上腺肿瘤的CT表现,以提高诊断水平。方法对32例经手术病理证实的肾上腺肿瘤进行回顾性分析,在CT图像上,观察病变的位置、大小、形态、密度、边缘,测量病灶增强前后的CT值。结果醛固酮腺瘤9例,体积较小且密度低,增强后轻度增强;皮质醇腺瘤5例,瘤体较大,边界清,密度略低于正常肾上腺组织;无功腺瘤1例;结节增生5例,为等或稍低密度影,增强后强化较明显;嗜铬细胞瘤4例,体积较大,密度不均,可见多个囊变坏死区;皮质腺癌2例,肿块形态不规则,边缘模糊,密度不均匀,易发生大片坏死及点状钙化;转移瘤3例;神经纤维瘤、神经节瘤及髓性脂肪瘤各1例。结论CT表现与肾上腺肿瘤的病理基础有关,结合临床资料可提高肾上腺肿瘤的诊断真确率。
Objective To investigate the CT features of different pathological types of adrenal tumors in order to improve the diagnosis. Methods Thirty-two cases of adrenal tumors confirmed by surgery and pathology were retrospectively analyzed. The location, size, shape, density, and margin of the lesions were observed on CT images. The CT values before and after lesion enhancement were measured. Results In 9 cases of aldosterone adenoma, the volume was small and the density was low. After enhancement, it was slightly enhanced. In cortisol adenoma in 5 cases, the tumor was large, the border was clear, and the density was slightly lower than that of normal adrenal tissue. There was 1 case of reactive adenoma. Nodular hyperplasia occurred in 5 cases, equal or slightly lower density, enhanced after enhancement; pheochromocytoma in 4 cases, large volume, uneven density, visible multiple cystic necrosis area; cortical adenocarcinoma in 2 cases, masses Irregular form, blurred edges, uneven density, prone to massive necrosis and punctate calcification; metastases in 3 cases; neurofibroma, ganglion tumor and myeloma lipoma in 1 case each. Conclusion CT findings are related to the pathological basis of adrenal tumors. Combined with clinical data, the accuracy of diagnosis of adrenal tumors can be improved.