摘要
目的:分析原发性肾上腺皮质腺癌(ACC)的CT表现与病理特点,以提高诊断的准确性。方法:回顾性分析经手术与病理证实的16例ACC的CT图像特点、临床资料及病理学特点。结果:功能性ACC6例,无功能性ACC 10例;16例ACC中,位于左侧肾上腺7例,右侧9例,大小4.4cm×5.4cm~14cm×17cm,最小直径<5cm3例;CT平扫表现为分叶状或不规则7例,类圆形3例,椭圆形6例;边界模糊9例,边界较清7例;内见点状或条状钙化5例;病灶内坏死形态不规则15例。16例ACC增强后全部表现为不均匀强化,坏死边缘显示较模糊。其中6例ACC中央出现星芒状、裂隙状较宽区域坏死;2例肿瘤实质大部分坏死形成假囊肿样。病理上肿瘤血管丰富,多见广泛出血、坏死,有血管包膜浸润。结论:ACC的CT表现具有一定的特征性,与其病理改变有一定的关系。掌握这些有助于提高诊断正确率。
Purpose: To analyze the CT characteristics and pathological features of primary adrenocortical carcinoma(ACC), to improve the diagnostic accuracy of it.Methods: The CT manifestations, clinical information and pathological features of 16 ACC cases proved by surgery and pathology results were analyzed retrospectively.Results: There were 6 functional tumors and 10 non-functional masses. Seven of 16 lesions were located in the left adrenal gland, 9 in the right. The size of the tumors was ranged 4.4 cm×5.4 cm-14 cm×17 cm, 3 lesions were with diameter less than 5.0 cm. On plain CT: 7 lesions were lobulated or irregular, 3 lesions were round, 6 lesions were oval-shaped; 9 lesions were ill-defined and 7 cases were well defined; 5 lesions showed with spot or strip-like calcification; 15 cases were with necrosis; All 16 cases were inhomogeneous enhanced after contrast administration,and 2 cases with necrosis showed pseudocyst-like feature. The pathological result showed that all tumors were with illustrated confluent blood vessels, with hemorrhage and necrosis. The membrane of the vessels were infiltrated.Conclusion: The CT manifestations of adrenocortical carcinoma are characteristic, they have certain relationship with the pathological changes. Familiar with these will improve their diagnostic accuracy..
引文
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