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儿童肾上腺皮质肿瘤的临床及影像学分析

作者:李晋荣

所属单位:河南省商丘市第一人民医院放射科 (河南 商丘 476100)

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摘要

目的 对于儿童肾上腺皮质肿瘤的临床和影像学诊断进行分析。方法 将我院肾上腺皮质肿瘤的18例患儿作为研究对 象,对所有患儿实行CT和MRI诊断,分析其MRI和CT的表现并与手术病理情况进行比较。结果 CT平扫后肾上腺皮质 囊肿表现为稍低密度肿块,MRI扫描后则出现了稍长的信号T1、T2;增强扫描后CT和MRI影像显示肾上腺皮质肿瘤动 脉期出现不均匀的轻度强化,静脉期强化减弱,肾上腺皮质癌2例,1例扫描显示肿瘤密度不均匀,实行增强扫描后 患者肿瘤的实质性强化时间较长,另1例MRI扫描显示为轻度的较为均匀的强化。结论 除单纯囊肿外,儿童肾上腺 皮质肿瘤影像学表现缺乏特异性表现,确诊需要影像学与临床病理相结合。

Objective To analyze the clinical imaging characteristics in children with adrenal cortical carcinoma. Methods 18 children with adrenal cortical carcinoma in our hospital were selected. The CT and MRI examination was conducted. After CT and MRI examinations, the clinical manifestations and pathological conditions were compared. Results Based on the CT plain scan, the adrenal cortical cyst was featured as low density of lump, based on MRI examination, there were longer wave of T1 and T2 signals, after enhancement scan of CT and MRI examination, the adrenal cortical carcinoma was featured as unevenly mild enhancement at arterial phase and decreasing enhancement at venous phase, there were two cases of adrenal cortical carcinoma, one case was featured as uneven density and longer substantial enhancement time after enhancement scanning, after MRI scan, one case was featured as rather evenly mild enhancement. Conclusion Except for cortical cyst, the imaging manifestations of adrenal cortical carcinoma are lack of specificity. The imaging and pathological examination shall be combined in clinical practice.

【关键词】肾上腺皮质肿瘤;临床特征;影像学分析

【中图分类号】R736.6

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2019.01.027

前言

儿童肾上腺皮质肿瘤最常见的肿瘤为神经母细胞 瘤(NB),而肾上腺囊肿、髓外造血、皮脂腺瘤则在儿 童较为少见,因此在临床诊断中容易误诊为神经母细 胞瘤(NB),而不同的影像学则对患儿疾病的诊断有不 同的效果,在诊断后与病理学进行诊断,提高对儿童 肾上腺肿瘤的鉴别[1]。本文选取18例肾上腺皮质肿瘤 的患儿作为研究对象,分析其诊断效果,研究内容如 下。