论文部分内容阅读
目的探讨多层螺旋CT(MSCT)增强扫描在恶性肿瘤患者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 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3min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、平扫CT值及增强扫描各期CT值均高于肾上腺腺瘤(P<0.05)。结论 MSCT增强扫描可反映肾上腺病变的血流动力学变化,为肾上腺转移瘤和腺瘤的鉴别诊断提供有力的依据。
Objective To investigate the value of multi-slice spiral CT (MSCT) enhanced scan in the differential diagnosis of adrenal adenomas and metastases in patients with malignant tumors. Methods Thirty-nine patients with adrenal nodules who had malignant neoplasm were enrolled in this study. All patients underwent MSCT scan and enhanced scan to analyze the features of MSCT enhancement of adrenal adenomas and metastases in patients with malignant tumors. Results Totally 35 adrenal metastases were found in 25 patients, presenting as round, oval or irregular nodules with an average diameter of (2.6 ± 0.7) cm, partial density unevenness and solid portion CT value of (32.8 ± 6.1) Hu. The real part of enhanced arterial phase of the enhanced CT scan was (49.5 ± 6.9) Hu. The solid part of the venous phase scan was further enhanced with a CT value of (74.9 ± 8.0) Hu At 3min, the CT value of the real part of the tumor was 72.4 ± 7.6 Hu. Fourteen patients had 14 adrenal adenomas with a CT value of (19.6 ± 4.5) Hu and a tumor diameter of (1.8 ± 0.4) cm. Tumors in enhanced arterial phase showed mild to moderate enhancement with a CT value of (43.8 ± 8.1) Hu markedly enhanced during the venous phase. The average CT value was (67.7 ± 9.2) Hu, the degree of enhancement was significantly decreased, and the average CT value was (55.9 ± 8.8) Hu. Adrenal metastases diameter, CT scan and enhanced CT scan were higher than the adrenal adenoma (P <0.05). Conclusion MSCT enhanced scan can reflect the hemodynamic changes of adrenal lesions, and provide a strong basis for the differential diagnosis of adrenal metastases and adenomas.