内分泌系统的影像诊断课件.ppt

* Because of their relatively tenuous blood supply, pituitary adenomas are prone to develop infarction or hemorrhage headache, vomiting, ophthalmoplegia,or visual loss * Because of their relatively tenuous blood supply, pituitary adenomas are prone to develop infarction or hemorrhage headache, vomiting, ophthalmoplegia,or visual loss * * 腹部平片的作用仅限于观察肾上腺钙化。钙化通常是新生儿出血的后遗改变，在成人期多半吸收了。钙化经常在神经母细胞瘤中见到，偶尔也可见于成人的良性和恶性肿瘤。慢性肉芽肿性疾病，例如结核，常是肾上腺钙化的来源。 其原理是MIBG在化学结构上类似去甲肾上腺素，能被肾上腺髓质和嗜铬细胞瘤摄取。故对嗜铬细胞瘤检查有特异性，能鉴别肾上腺或肾上腺以外其他部位的肿瘤是否为嗜铬细胞瘤。具有安全、特异和准确率高的优点 当有上腹大肿块时，常常不易确定它是来源于肝，肾还是其它的后腹膜结构。在这种情况下，证明肿瘤的主要血供是源于肾上腺动脉是很有用的。肾上腺静脉造影比动脉造影更常用，通过取血样分析，可以定位小的功能性肿瘤。 * Both adrenal glands (arrows) are symmetrically enlarged * * A homogeneous, rounded mass is detected in the right adrenal gland. * Adenoma on chemical shift imaging. A. The in-phase image reveals a small, rounded homogeneous left adrenal mass. B. The loss in signal intensity on the opposed phase image indicates the presence of lipid. * * * A left adrenal mass (P) is identified on this unenhanced abdominal CT examination. * (a) Contrast-enhanced axial CT scan demonstrates an enlarged right adrenal gland with internal calcifications (arrow). (b) Coronal reformatted image from the axial data set demonstrates the relationship of the right adrenal pheochromocytoma (arrow) to the upper pole of the right kidney and the liver. * Because of their relatively tenuous blood supply, pituitary adenomas are prone to develop infarction or hemorrhage headache, vomiting, ophthalmoplegia,or visual loss * * Because of their relatively tenuous blood supply, pituitary adenomas are prone to develop infarction or hemorrhage headache, vomiting, ophthalmoplegia,or visual loss 肾上腺小结 显示垂体病变的最佳方法 肾上腺腺瘤富含脂肪 嗜铬细胞瘤 肾上腺转移瘤是最常见的恶性肿瘤，常来源于 - CT -CT密度较低，强化均匀 MRI反相位信号明显减低 -强化不均匀，10%异位 -肺、乳腺、肾 甲状腺的解剖 部位：甲状软骨下方、气管两旁 分左右两叶，中间以峡部相连 两层被膜：内层——甲状腺固有被膜 外层——甲状腺外科被膜 影像学检查方法Imaging modalities 平片：不能直接显示，观察气管的压迫情况 CT： 能显示，高密度（碘） MR： 能显示，中等信号 B超： 能显示，最