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目的:探讨肾上腺髓性脂肪瘤的影像学特点和诊治方法。方法:肾上腺肿瘤患者12例。男5例,女7例。平均年龄48(33～64)岁。左侧4例,右侧8例。血压高2例,腰腹部疼痛1例,无特异性症状9例。行B超、CT及MRI检查,术前提示为肾上腺占位,其中肾上腺髓性脂肪瘤10例,嗜铬细胞瘤1例,肾上腺肿瘤1例。12例均行肾上腺肿瘤切除术,其中开放手术7例,腹腔镜手术5例。结果:12例手术均顺利完成。平均手术时间1.5 h,平均术中出血量50 ml。术后无明显外科并发症,平均7天顺利出院。切除肿瘤最小3.0 cm×3.5 cm×4.0 cm,最大6.5 cm×7.5 cm×8.0 cm,病理诊断均为肾上腺髓性脂肪瘤。术后随访0.5～8年(平均2年),所有患者临床症状消失,B超及CT检查未见肿瘤复发及恶性变。结论:肾上腺髓性脂肪瘤多无特异性临床表现,术前诊断主要靠影像学检查,确诊依赖于病理检查;手术切除预后良好,其中腹腔镜手术创伤小,疗效满意,为治疗本病的理想方法。
Objective: To investigate the imaging features and diagnosis and treatment of adrenal myelolipoma. Methods: Twelve patients with adrenal tumors. 5 males and 7 females. The average age of 48 (33 ~ 64) years old. 4 cases on the left and 8 cases on the right. 2 cases of high blood pressure, lumbar and abdominal pain in 1 case, 9 cases of non-specific symptoms. Line B ultrasound, CT and MRI examination, preoperative tips for adrenal space, of which 10 cases of adrenal lipoma, pheochromocytoma in 1 case, 1 case of adrenal tumors. Twelve cases underwent adrenalectomy, including 7 cases of open surgery and 5 cases of laparoscopic surgery. Results: All 12 cases were successfully completed. The average operation time was 1.5 h, with an average blood loss of 50 ml. No significant postoperative surgical complications, an average of 7 days were discharged. The smallest tumor was 3.0 cm × 3.5 cm × 4.0 cm and the largest was 6.5 cm × 7.5 cm × 8.0 cm. The pathological diagnosis was all adrenal lipoma. The patients were followed up for 0.5 to 8 years (mean 2 years). The clinical symptoms of all patients disappeared. There was no tumor recurrence and malignant transformation in B ultrasound and CT. CONCLUSIONS: There are no specific clinical manifestations of adrenal myelolipoma. The preoperative diagnosis mainly depends on the imaging examination, and the diagnosis depends on the pathological examination. The surgical resection has a good prognosis, and the laparoscopic trauma is small and the curative effect is satisfactory, which is the ideal treatment for this disease method.