肾上腺节细胞神经瘤的螺旋CT诊断价值.DOCVIP

临床医学论文-肾上腺节细胞神经瘤的螺旋CT诊断价值 【摘要】? 目的 分析节细胞神经瘤的CT影像学征象,以提高诊断的正确性。方法 回顾性分析5例节细胞神经瘤行螺旋CT平扫及多期增强扫描的临床资料。 结果 CT平扫为均匀低密度(5/5例),伴有钙化(1/5例),增强扫描后强化不明显(4/5例)或仅见少量条线形强化(1/5例),注射对比剂后呈延迟强化(1例)；肿瘤大多边界清晰,沿周围器官间隙呈嵌入性生长,邻近大血管被包绕穿行于肿物之中或受压移位为其特征性表现之一。 结论 肾上腺节细胞神经瘤有一定的CT影像特点,CT可正确定位和做出较准确的定性诊断。 【关键词】? 神经节瘤 肾上腺肿瘤 体层摄影术 X线计算机 ??? ABSTRACT:? Objective? To explore the spiral CT findings of adrenal ganglioneuromas and to evaluate its clinical value.? Methods? All five patients with adrenal ganglioneuromas confirmed by surgery and pathology were underwent spiral CT plain and multiple phases enhanced scanning before operation.?The CT images were reviewed and analyzed retrospectively in comparison with surgical and pathological results.?Results?The masses revealed homogeneous low density on CT plain scanning.?No or mild linear enhancement were demonstrated after administration of contrast medium.?The masses were well defined and showed a tendency of wedging into the space between the adjacent organs and structures and encasing the large vessels.? Conclusion? Certain characteristic CT features provide a valuable clue to the diagnosis of adrenal ganglioneuroma.? CT examination plays an essential role on its accurate localizing diagnosis and qualitative diagnosis. ??? KEY WORDS:? adrenal gland neoplasms; ganglioneuroma; tomography, Xray computed ??? 节细胞神经瘤又称神经节细胞瘤,是一种起源于原始神经脊细胞的良性肿瘤,多发生于颈部至盆腔的交感神经节；后纵隔和腹膜后的发生率最高(56%),发生于肾上腺者少见(13%～30%)[1]。近年来,随着超声、CT及MRI等影像学诊断技术的发展和应用,该病的发现率有所增高。笔者收集2002年8月－2006年3月经多层螺旋CT平扫及多期增强扫描检查发现、并经手术与病理证实的肾上腺节细胞神经瘤5例,对其CT征象进行回顾性分析,以提高该病影像诊断的正确性。 　　1? 对象与方法 　　1.1? 对象? 　　5例中,男性2例,女性3例,年龄(34.25±5.32)岁(33～42岁)。3例体检时由B超发现病变；2例因腹部闷痛不适,行超声或CT检查发现病变。均无家族史。血皮质醇、醛固酮、电解质、24 h尿皮质醇、24 h尿醛固酮、3甲基4羟基苦杏仁酸(VMA)检查均正常。1.2? 检查方法? CT扫描采用美国通用电气公司(General Electric,GE)的Lightspeed QX/i型多层螺旋CT机,空腹,扫描前30 min和即刻分别口服2%泛影葡胺溶液400 mL和100 mL充盈胃肠道,肾上腺的扫描范围从肾上腺上2 cm至肾门部,扫描条件:120 kV,300 mA,平扫层厚5 mm,层距5 mm,增强后扫描层厚5 mm,小病变追加薄层扫描,层厚3 mm或1 mm,肾上腺区平扫后行多期增强扫描,使用非离子型对比剂优维显(Ultravist 300),通过压力注射器由肘前静脉注入,速度为3