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含细胞外脂肪肾上腺腺瘤CT和MRI表现
作者:孙力军  张丽红  王林省  王军业  郭沐洁  韩磊 
单位:1. 济宁医学院附属医院肿瘤科  山东 济宁 272000 
2.
 济宁市第一人民医院CT室  山东 济宁 272002 
关键词:肾上腺肿瘤/诊断 体层摄影术 X线 诊断 鉴别 回顾性研究 
DOI:R736.6;R730.4
出版年,卷(期365bet娱乐官网网址):页码:2015,30(5):451-454
摘要:
目的 探讨含细胞外脂肪肾上腺腺瘤的CT和MRI影像学特点,提高对该类肿瘤的认识,减少误诊率。方法 结合文献回顾性分析7例含细胞外脂肪肾上腺腺瘤的临床、影像学特点及病理资料,7例均行CT平扫及增强扫描,其中4例行MRI平扫。结果 7例含细胞外脂肪肾上腺腺瘤均以非脂成分为主,脂肪呈多灶状分布,3~8个不等,大小约为1.4~7.2 mm。CT显示局灶性脂肪密度影,CT值-110~-46 HU;非脂成分CT平扫值均为5.8~13.4 HU,5例脂肪灶旁见点状钙化影;CT增强扫描呈明显不均匀强化,4例脂肪灶旁见结节状强化,1例脂肪灶旁合并瘤内动静脉血管扩张。4例脂肪灶在T1WI脂肪抑制序列均呈低信号;4例非脂成分在T1WI正相位均为稍高信号,T1WI反相位均为低信号。结论 含细胞外脂肪肾上腺腺瘤CT和MRI表现具有特征性,非脂成分的影像特征对该瘤的诊断和鉴别诊断具有重要价值。
Objective To review the CT and MRI findings of adrenal adenoma containing ectocytic fat. Methods Seven patients with adrenal adenoma containing ectocytic fat underwent non-enhanced and enhanced CT scan and 4 of them also underwent non-enhanced MRI examination. Clinical data and imaging findings of 7 patients were retrospectively reviewed. Results Seven cases all had dominant non-fat components. Fatty foci were multiple (3~8) with diameters of 1.4~7.2 mm. CT values of fatty foci were-110~-46 HU, while CT values of non-fat components were 5.8~13.4 HU. There were calcifications near fatty foci in 5 cases. All cases enhanced heterogeneously. Greatly-enhanced nodules near fatty foci were detected in 4 cases, tumor arteries and veins were dilated in one case. Fatty foci were hypointense on fat-suppressed T1WI while hyperintense on non-fat-suppressed T1WI. The non-fat components of 4 cases showed high signal on the in-phase T1WI with signal dropout on the out-of-phase T1WI. Conclusion Adrenal adenoma containing ectocytic fat has some characteristics on CT and MRI scanning. Imaging features of non-fat components are helpful for qualitative and differential diagnosis of the tumor.
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