肾上腺腺瘤与非腺瘤的CT鉴别诊断

摘要

Objective To evaluate the diagnostic efficacy of CT in differentiating adrenal adenoma from non-adenoma. Methods CT features and pathological characteristics of 58 adrenal masses proved by surgery and pathology in o6 cases were retrospectively analyzed. All patients underwent precontrast and contrast-enhanced CT scan at 1 minute and 5 minutes after injection of contrast medium. Results The threshold of CT unenhanced attenuation, relative and absolute washout rate of enhancement at precontrast and contrast-enhanced CT scan at 1 minute and 5 minutes delayed were valuable in differentiating adenomas from non-adenomas, there was significant difference between them(P＜O. 05). When the diagnostic criteria with unenhanced attenuation of ≤19 HU, 5-minute enhanced attenuation of≤46 HU, perecntage enhancement washout ratio (PEW) of ≥63％ and relative PEW(RPEW) of ≥31％ were assumed as the threshold,the sensitivity in diagnosing adenomas and lipid-poor adenomas was 96％ and 86％ respectively. Conclusion The criterion based on the washout percentage and the CT attenuation at precontrast enhancement and contrast-enhanced is of great value in differentiaring adrenal adenoma from non-adenoma.%目的 探讨肾上腺腺瘤与非腺瘤的CT鉴别诊断价值.方法 回顾性分析经手术和随访证实的56例(58个病灶)肾上腺肿瘤的CT表现及病理组织学特征,患者均行CT平扫及1 min、5 min增强扫描,对诊断参数进行分析并对照病理组织学表现,对肾上腺肿瘤做出正确的诊断.结果 腺瘤与非腺瘤在CT平扫及增强后1 min、5 min的CT值、相对廓清率和绝对廓清率的差异均有统计学意义(P＜0.05),以平扫时CT≤19 HU,延时5 min时CT≤46 HU,绝对廓清率≥63%,相对廓清率≥31%为阈值相结合作为诊断标准时,诊断腺瘤或乏脂性腺瘤的敏感性分别为96%或86%.结论 以肿瘤平扫及增强后的CT值与肿瘤的廓清率作为联合标准,对腺瘤(包括乏脂性腺瘤)与非腺瘤的鉴别诊断有较高的价值.