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肾上腺节细胞神经瘤的CT、MRI诊断与鉴别诊断

Clinical value of CT and MRI in diagnosis and differential diagnosis of adrenal ganglioneuroma

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【作者】 王东孟利民毕永民张挽时

【Author】 WANG Dong;MENG Limin;BI Yongmin;ZHANG Wanshi;Department of MRI,Air Force General Hospital;

【机构】 空军总医院磁共振科

【摘要】 目的探讨CT和MRI对肾上腺节细胞神经瘤的诊断及鉴别诊断价值。方法对8例经手术和病理证实的肾上腺节细胞神经瘤的CT、MRI表现进行回顾性分析。8例患者均作了CT平扫和增强扫描,5例同时作了MRI平扫和增强扫描。结果 8例均为单发病灶,位于右侧肾上腺5例,左侧肾上腺3例。肿瘤最大直径为2.8~7.6 cm,平均6.3 cm,CT平扫为等或低密度,3例有钙化灶;MRI T1WI呈低或等信号,T2WI肿瘤呈高信号或不均匀稍高信号,3例见漩涡征;增强早期肿瘤轻度强化、延迟后进行性增强。1例类似于肾上腺假性囊肿的CT、MRI表现。肿瘤有钻缝样生长及包绕血管而不侵犯血管的特点。结论 CT、MRI的影像学表现显示,肾上腺节细胞神经瘤主要表现为柔软的较大肿块,可沿器官间隙钻缝样生长,增强扫描肿瘤呈渐进性延迟强化,有助于和肾上腺其他病变的鉴别。

【Abstract】 Objective To investigate the value of CT and MRI in the diagnosis and differential diagnosis of rare adrenal ganglioneuroma. Methods The CT and MRI features of eight cases of adrenal ganglioneuroma verified surgically and pathologically were investigated retrospectively. All these cases underwent CT scan and f ive of them underwent MRI. Results All the patients had a solitary lesion that was in the right adrenal gland in five cases and in the left one in three cases. The diameter of the lesions ranged from 2.8 to 7.6 cm, with an average of 6.3 cm. Pre-contrast CT identified the lesions as isointense or hypointense. Calcification was observed inside three tumors.On MRI images, the tumors displayed isointense or hypointense signals on T1 WI and hyperintense signals on T2 WI, and whirl signs were seen inside three tumors. On contrast images, the tumors were enhanced slightly in the early phase and gradually more significantly in the delayed phase. The CT and MRI features of one case of adrenal ganglioneuroma were similar to those of adrenal pseudocysts. The tumor showed growth "through cracks" or surrounding the blood vessels without invading them. Conclusion On CT and MRI images, the adrenal ganglioneuroma shows a large soft mass with growth "through cracks",and displays gradual enhancement on postcontrast images, thus contributing to the differentiation from other adrenal diseases.

  • 【文献出处】 空军医学杂志 ,Medical Journal of Air Force , 编辑部邮箱 ,2017年03期
  • 【分类号】R445.2;R730.44;R736.6
  • 【被引频次】8
  • 【下载频次】189
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