肾上腺常见肿瘤的CT及MRI诊断准确性分析

摘要/Abstract

摘要： 目的研究肾上腺常见肿瘤的CT及MRI诊断准确性。方法本次纳入2018年1月~2020年12月在东明县中医医院疑诊为肾上腺肿瘤的患者60例展开研究,均进行CT检查、MRI检查,以手术病理检查结果为金标准,比较两种检查方式的诊断结果。结果共有58例患者确诊为肾上腺肿瘤,良性肿瘤、恶性肿瘤分别为45例、13例。MRI检查的检出率、符合率高于CT检查,差异有统计学意义（P<0.05）。CT检查的肾上腺良性、恶性肿瘤定位诊断准确率高于MRI检查,MRI检查的良性肿瘤定性诊断准确率高于CT检查,差异有统计学意义（P<0.05）;MRI检查的特异度、准确性高于CT检查,差异有统计学意义（P<0.05）。结论相较于CT检查,MRI检查的肾上腺肿瘤病理类型检出率更高。在肾上腺良性、恶性肿瘤定位、定性诊断中,CT检查、MRI检查各有优劣,临床在实际工作中应合理选择检查方式,或可将两种检查方式结合应用,在经CT定位诊断后再经MRI检查定性诊断,以提升诊断准确性。

关键词: 肾上腺, 肿瘤, CT, MRI, 诊断

Abstract: Objective To study the diagnostic accuracy of CT and MRI in common adrenal tumors. Methods From January 2018 to December 2020, 60 patients suspected of adrenal tumors were studied in Dongming County Hospital of Traditional Chinese Medicine. CT and MRI were performed, and the diagnosis results of the two methods were compared with the results of surgical and pathological examination as the gold standard. Results A total of 58 patients were diagnosed as adrenal tumors, 45 as benign tumors and 13 as malignant tumors. The detection rate and coincidence rate of MRI were higher than that of CT, the difference was statistically significant (P<0.05). The accuracy of localization diagnosis of benign and malignant adrenal tumors by CT was higher than that by MRI, and the accuracy of qualitative diagnosis of benign adrenal tumors by MRI was higher than that by CT, the difference was statistically significant (P<0.05); The specificity and accuracy of MRI were higher than that of CT, the difference was statistically significant (P<0.05). Conclusion Compared with CT examination, MRI examination has a higher detection rate of pathological types of adrenal tumors. In the localization and qualitative diagnosis of benign and malignant adrenal tumors, CT examination and MRI examination have their own advantages and disadvantages. In clinical practice, we should choose the examination methods reasonably, or combine the two examination methods, and then make qualitative diagnosis by MRI after CT localization diagnosis, so as to improve the diagnostic accuracy.

Key words: adrenal gland, tumor, CT, MRI, diagnose

中图分类号:

R445

李忠民. 肾上腺常见肿瘤的CT及MRI诊断准确性分析[J]. 中华养生保健, 2022, 40(10): 7-10.

LI Zhong-min. Accuracy Analysis of CT and MRI Diagnosis of Common Adrenal Tumors[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(10): 7-10.

参考文献

[1] 何玉鹏,高知玲,高雨佳,等.肾上腺肿瘤及肿瘤样病变多层螺旋CT影像特征分析[J].实用放射学杂志,2019,35(1):60-64.
[2] 张雪. 肾上腺嗜铬细胞瘤的CT与MRI诊断价值[J].影像研究与医学应用,2020,4(11):10-11.
[3] 闫海波. 双源CT在鉴别诊断肾上腺乏脂肪腺瘤、小转移瘤中的应用价值[J].中国CT和MRI杂志,2020,18(2):106-108,112.
[4] 白德波,孟宪平,姜岐涛.肾上腺间质肿瘤的CT和MRI诊断[J].影像研究与医学应用,2018,2(17):203-205.
[5] 吴阶平,马永江.实用泌尿外科学[M].北京:人民军医出版社,1991: 228-237.
[6] Nermoen I, Falhammar H.Prevalence and characteristics of adrenal tumors and myelolipomas in congenital adrenal hyperplasia: a systematic review and meta-analysis[J]. Endocrine Practice, 2020, 26(11): 1351-1365.
[7] 李丹菲,杨钦,陈自谦,等.肾上腺髓质脂肪瘤CT和MRI表现与其病理特点分析[J].医学影像学杂志,2017,27(11):2154-2159.
[8] 杨广洋,龙海清,张英,等.动态增强CT联合MRI对肾上腺腺瘤与转移瘤的鉴别诊断价值[J].中国医师杂志,2019,21(12):1845-1848.
[9] 吴志异. CT和MRI诊断肾上腺良、恶性肿瘤的作用分析[J].中国卫生产业, 2013,10(19):112-113.
[10] 黎勇. 肾上腺良恶性肿瘤的CT及MRI诊断价值探讨[J].影像研究与医学应用,2019,3(5):86-87.
[11] 陈真平,李志娟,邹玉林,等.CT、MRI在诊断和鉴别肾上腺良恶性肿瘤的作用[J].深圳中西医结合杂志,2019,29(14):66-67.
[12] 宋华英. 3.0T MRI平扫对肾上腺肿瘤患者诊断准确率的影响[J].现代医用影像学,2019,28(3):566-567.
[13] 吴兆华,王勇.不同影像学检查对肾上腺肿瘤的诊断价值[J].深圳中西医结合杂志,2018,28(22):84-85.
[14] 陆舜钦,管竹春,鲍丽娟.1.5T MRI与螺旋CT对肾上腺肿瘤诊断价值对比分析[J].深圳中西医结合杂志,2017,27(9):74-76.
[15] Lee J Y, Kang B S, Shim H S, et al.Clear cell hidradenoma: characteristic imaging features on ultrasonography, computed tomography, and magnetic resonance imaging[J]. Journal of Ultrasound in Medicine, 2018, 37(8): 1993-2001
[16] Matsuura K, Inoue K, Hoshino E, et al.Utility of magnetic resonance imaging for differentiating malignant mesenchymal tumors of the uterus from T2-weighted hyperintense leiomyomas[J]. Japanese journal of radiology, 2021,2(6): 1-11.
[17] 郭秀玲,赵丹,李新星,等.肾上腺腺瘤的MRI诊断[J].中国医药指南,2016,14(22):183-184.