创伤性肾上腺损伤的影像学诊断及临床应用
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摘要
肾上腺是腹膜后器官,体积细小、位置深在,周围由肾筋膜及脂肪包绕,在外伤时可以对肾上腺起到很好的缓冲及保护作用,因此创伤性肾上腺损伤是一种较为少见的病变。近年来随着外伤患者逐渐增多及各种影像学检查方法的不断更新及广泛应用,肾上腺损伤的发生率也越来越高,熟悉肾上腺损伤的各种影像学表现有助于影像科医师做出快速正确的诊断,为临床医师提供更有价值的信息。
The adrenal gland is a retroperitoneal organ with a small size and deep position. Traumatic adrenal injury is rare due to the surrounding Gerota' s fascia and fat,which can play a good buffering protection for adrenal glands during trauma. In recent years,with the gradual increase of trauma patients and the wide application of imaging examination,the incidence of adrenal injury is higher than before. It is helpful for imaging doctors to make correct diagnosis to be familiar with all kinds of imaging findings of adrenal injury to provide more valuable information for the clinicians.
The adrenal gland is a retroperitoneal organ with a small size and deep position. Traumatic adrenal injury is rare due to the surrounding Gerota' s fascia and fat,which can play a good buffering protection for adrenal glands during trauma. In recent years,with the gradual increase of trauma patients and the wide application of imaging examination,the incidence of adrenal injury is higher than before. It is helpful for imaging doctors to make correct diagnosis to be familiar with all kinds of imaging findings of adrenal injury to provide more valuable information for the clinicians.
引文
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[22]季中,王淑珍,陈伟建.肾上腺损伤的CT和MR表现与临床应用价值[J].中国现代医师,2014,10(52):59-64.
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[24]窦晓霞,刘维,吴彩玲,等.肾上腺血肿超声表现1例[J/CD].中华医学超声杂志(电子版),2010,7(12):2187-2189.
[25]代庆华.外伤性肾上腺血肿的CT表现[J].现代医用影像学,2012,21(2):104-106.
[26]Stowasser M.Update in primary aldosteronism[J].J Clin Endocrinol Metab,2015,100(1):1-10.
[27]江昌新,曾智,王婷,等.肾上腺皮质疾病的临床病理学特点分析[J].中华泌尿外科杂志,2012,33(3):165-170.
[28]何明宸,许茂盛,喻迎星,等.嗜铬细胞瘤的CT与MRI诊断[J].医学影像学杂志,2014,7(24):1259-1261.
[29]Rowe SP,Mathur A,Bishop JA,et al.Computed Tomography appearance of surgically resected adrenal hematomas[J].J Comput Assist Tomogr,2016,40(6):892-895.
[30]Jordan E,Poder L,Courtier J,et al.Imaging of nontraumatic adrenal hemorrhage[J].Am J Roentgenol,2012,199(1):91-98.
[31]Ibrahim K,Ersin GD,Vedia O,et al.Idiopathic adrenal hematoma mimicking neoplasia:A case report[J].Int J Surg Case Rep,2016,28(C):15-17.
[32]Song YW,Yu H,Park K,et al.A Case of spontaneous regression of idiopathic bilateral adrenal hemorrhage in a middle aged woman:1 year follow-up[J].Acad J,2016,12(1):85-90.
[33]Ghasemi M,Beigi AA,Behnaz F,et al.Spontaneous adrenal hematoma in a pregnant woman:A case report[J].Emerg(Tehran),2017,5(1):e59-61.
[34]Lee S,Choi D,Jeong WK,et al.Frequency of hemorrhagic complications on abdominal CT in patients with warfarin therapy[J].Clin Imaging,2016,40(3):435-439.
[2]Daly KP,Ho CP,Persson DL,et al.Traumatic retroperitoneal injuries:Review of multidetector CT findings[J].Radiographics,2008,28(6):1571-1590.
[3]王建伟,满立波,黄广林,等.创伤性肾上腺损伤的临床特点分析[J].中华医学杂志,2014,94(22):1733-1735.
[4]Sinelnikov AO,Abujudeh HH,Chan D,et al.CT manifestations of adrenal trauma:Experience with 73 cases[J].Emerg Radiol,2007,13(6):313-318.
[5]李松年,唐光健.现代全身CT诊断学[M].北京:中国医药科技出版社,2017:1652-1653.
[6]Rana AI,Kenney PJ,Lockhart ME,et al.Adrenal gland hematomas in trauma patients[J].Radiology,2004,230(3):669-675.
[7]周康荣.腹部CT诊断学[M].上海:上海医科大学出版社,1993:296-298.
[8]To'o KJ,Duddalwar VA.Imaging of traumatic adrenal injury[J].Emerg Radiol,2012,19(6):499-503.
[9]李月河,李钢,贾春岩,等.闭合性肾上腺外伤的CT增强表现[J].临床放射学杂志,2015,34(7):1111-1113.
[10]Tan GX,Sutheraland T.Adrenal congestion preceding adrenal hemorrhage on CT imaging:A case series[J].Abdom Radiol(NY),2016,41(2):303-310.
[11]魏秀红,田瑞霞.肾上腺外伤性血肿的CT诊断[J].医学影像学杂志,2016,26(7):1258-1260.
[12]Mehrazin R,Derweesh IH,Kincade MC,et al.Adrenal trauma:Elvis Presley Memorial Trauma Center experience[J].Urology,2007,70(5):851-855.
[13]徐官珍,邹文远,付传明,等.外伤性肾上腺血肿诊断分析[J].理论与应用研究,2014,23(3):515-520.
[14]Sacerdote MG,Johnson PT,Fishman EK.CT of the adrenal gland:The many faces of adrenal hemorrhage[J].Emerg Radiol,2012,19(1):53-60.
[15]Untereiner O,Charpentier C,Grignon B,et al.Adrenal trauma:Medical and surgical emergency[J].Emerg Med J,2013,30(4):329-330.
[16]钟学兰.外伤性肾上腺血肿的多层螺旋CT诊断[J].实用医学影像杂志,2017,18(2):120-122.
[17]Chenl C,Lin WR,Yang S,et al.Successful arterial embolization for spontaneous adrenal hemorrahge:A case report[J].Urol Sci,2016,27(2):81-82.
[18]施海华,钱向宇,陈杰.外伤性肾上腺出血的多层螺旋CT诊断[J].医学影像学杂志,2015,25(1):114-116.
[19]任建,王翔,刘乃波,等.后腹腔镜肾上腺囊肿去顶术与切除术临床疗效分析[J].中华医学杂志,2013,93(26):2059-2061.
[20]李胜,邹文远,石思李,等.CT对肾损伤的诊断价值[J].医学临床研究,2011,28(9):1816-1818.
[21]顾乐锋,郑汉朋,邱乾德.外伤性急性肾上腺损伤CT诊断[J].医学影像学杂志,2012,22(2):229-232.
[22]季中,王淑珍,陈伟建.肾上腺损伤的CT和MR表现与临床应用价值[J].中国现代医师,2014,10(52):59-64.
[23]Sirlin CB,Brown MA,Andrade Barreto OA,et al.Blunt abdominal trauma:Clinical value of negative screening US scans[J].Radiology,2004,230(3):661-668.
[24]窦晓霞,刘维,吴彩玲,等.肾上腺血肿超声表现1例[J/CD].中华医学超声杂志(电子版),2010,7(12):2187-2189.
[25]代庆华.外伤性肾上腺血肿的CT表现[J].现代医用影像学,2012,21(2):104-106.
[26]Stowasser M.Update in primary aldosteronism[J].J Clin Endocrinol Metab,2015,100(1):1-10.
[27]江昌新,曾智,王婷,等.肾上腺皮质疾病的临床病理学特点分析[J].中华泌尿外科杂志,2012,33(3):165-170.
[28]何明宸,许茂盛,喻迎星,等.嗜铬细胞瘤的CT与MRI诊断[J].医学影像学杂志,2014,7(24):1259-1261.
[29]Rowe SP,Mathur A,Bishop JA,et al.Computed Tomography appearance of surgically resected adrenal hematomas[J].J Comput Assist Tomogr,2016,40(6):892-895.
[30]Jordan E,Poder L,Courtier J,et al.Imaging of nontraumatic adrenal hemorrhage[J].Am J Roentgenol,2012,199(1):91-98.
[31]Ibrahim K,Ersin GD,Vedia O,et al.Idiopathic adrenal hematoma mimicking neoplasia:A case report[J].Int J Surg Case Rep,2016,28(C):15-17.
[32]Song YW,Yu H,Park K,et al.A Case of spontaneous regression of idiopathic bilateral adrenal hemorrhage in a middle aged woman:1 year follow-up[J].Acad J,2016,12(1):85-90.
[33]Ghasemi M,Beigi AA,Behnaz F,et al.Spontaneous adrenal hematoma in a pregnant woman:A case report[J].Emerg(Tehran),2017,5(1):e59-61.
[34]Lee S,Choi D,Jeong WK,et al.Frequency of hemorrhagic complications on abdominal CT in patients with warfarin therapy[J].Clin Imaging,2016,40(3):435-439.