【摘要】 目的探讨MRI对原发肾上腺皮质癌的诊断及鉴别诊断价值。方法对18例经手术病理及临床证实的原发肾上腺皮质癌的MRI表现进行回顾性分析,18例患者分别作了MRI平扫和增强扫描,5例患者作了化学位移成像(CSI)序列扫描。结果 MRI对原发肾上腺皮质癌的定位、定性的准确性分别为89%和100%。原发肾上腺皮质癌典型表现为肿瘤体积较大(>5.0 cm),形态不规则,边界不清或侵犯周围结构,信号不均匀,内有不规则坏死区或出血灶,增强后肿瘤呈不均一明显强化;83%(15例)肿瘤见侵犯周围结构和(或)远处转移。与同相位图像比较,反相位图像上5例肿瘤的信号强度无明显下降。结论 MRI能很好地确定肿瘤的起源,观察肿瘤与邻近器官的关系以及下腔静脉受侵情况,对原发肾上腺皮质癌的诊断和鉴别诊断有重要的价值。更多还原

【Abstract】 Objective To investigate the value of MRI in the diagnosis and differential diagnosis of primary adrenal cortical carcinoma.Methods MRI features of primary adrenal cortical carcinomas veri-fied with operation and pathology were analyzed retrospectively in 18 cases.The unenhanced and con-trast-enhanced MRI was performed in 18 patients,and the chemical shift imaging(CSI) was performed in 5 cases.Results The accuracies of located and qualitatively diagnoses of MRI on primary adrenal cortical carcinomas were 88% and 100%.The characteristic findings of primary adrenal cortical carcinomas were a large soft tissue mass(>5.0cm),with irregular configuration,blurry margin or invasion surrounding structures,heterogeneous appearances with internal hemorrhage and necrosis,and inhomogeneous en-hancement.83%(15 cases) tumors had the surrounding structures invasion and/or distant metastases.Compared with in-phase(IP) images,5 tumors showed no loss of signal intensity on opposed-phase(OP) images.Conclusion MRI was useful in identifying the tumor location,investigating the relationship be-tween the tumor and the adjacent organs,and estimating the inferior venae cava invasion.MRI plays an impotent role in the diagnosis and differential diagnosis of primary adrenal cortical carcinoma.更多还原