肾上腺肿瘤影像学诊断策略教材分析.pptVIP

* BV can be used differentiating adenomas from nonadenomas BV can be used differentiating adenomas from nonadenomas * Metabolically active malignant lesions trapping 18F-FDG intracellularly, whereas most benign lesions do not Very early metastates could be detected Sensitivity 93%~ 100% and specificity 95% Some adenomas, inflammatory lesions demonstrate slightly increased uptake Necrotic or hemorrhagic malignant lesions may cause false-negative findings * DWI could not differentiate benign adrenal lesions from malignant lesions DWI could not help in distinguishing lipid-poor adenomas and non adenomas No discrepancies of ADC values among them * * 弥漫性肾上腺出血可发生于任何年龄，可发生于手术、化脓感染、烧伤、高血压等 慢性肾上腺出血 出血 （六）其它肿瘤样病变 大多为单侧，可以任意大小 病理上包括上皮的、内皮的、寄生虫性、假性囊肿 大多数病灶薄壁，无强化 肾上腺囊肿 囊肿 小结 1、肾上腺影像检查技术：超声、CT、MRI 2、肾上腺解剖特征：叶形，密度均匀，强 化均匀，径线小于10mm 3、肾上腺增大、肾上腺破坏、肾上腺肿块：区分肾上腺组织的异质性是诊断的关键 4、肾上腺肿瘤的诊断，临床及实验室检查很重要，影像学的价值在于病变定位及良恶性的区分。 Chest x-ray: wash out measurement This site provides a calculator to measure the wash-out of adrenal masses for differentiation of benign masses (usually adenomas) from malignant lesions (usually metastases). Imaging of Adrenal Incidentalomas: Current Status N. Reed Dunnick and Melvyn KorobkinAm. J. Roentgenol., Sep 2002; 179: 559 - 568. Adrenal Masses: Characterization with Combined Unenhanced and Delayed Enhanced CT Elaine M. Caoili et al.Radiology 2002;222:629-633. Management of the clinically inapparent Adrenal Mass Incidentaloma NIH State-of-the-Science Conference Feb 4-6, 2002. State of the Science Statement (html and pdf) and 3 day video conference Differentiation of adrenal adenomas from metastases with unenhanced computed tomography. Gufler H, Eichner G, Grossmann A, Krentz H, Schulze CG, Sauer S, Grau G.J Comput Assist Tomogr. 2004 Nov-Dec;28(6):818-22. eMedicine - Pheochromocytoma : Article by Anant Krishnan, MD Adrenal Masses in the Cancer Patient: Surveillance or Excision Ian C. Mitchell, Fiemu E. NwariakuThe Oncologist, Vol. 12, No. 2, 168-174 E