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目的探讨肾上腺髓样脂肪瘤的彩色多普勒超声表现和超声诊断价值。方法回顾性分析2005年3月-2010年9月58例61个经手术及病理证实的肾上腺髓脂肪瘤病灶的彩色多普勒超声表现,对病变的大小、内部回声特点及血流特点进行分析。结果在2005年3月-2007年12月的28个病灶超声诊断出肾上腺病变23个,正确率82.1%;诊断为髓脂肪瘤2个,正确率7.1%;漏诊1个,误诊4个。2008年1月-2010年9月,33个病灶超声诊断出肾上腺病变30个,正确率90.9%;诊断为髓脂肪瘤19个,正确率57.6%;无漏诊,误诊3个。52个病灶超声表现为边界清晰,形态基本规则,内部呈均匀中等强回声(与肾集合系统回声相当),内部未测及血流信号,另8个病灶表现为中等强回声与低回声相间。结论肾上腺髓样脂肪瘤具有特征性的彩色多普勒超声声像图表现,可用于发现病变并对多数肾上腺髓样脂肪瘤做出定性诊断。
Objective To investigate the color Doppler ultrasound and diagnostic value of adrenal myeloid lipoma. Methods The color Doppler echocardiography of 58 lesions of 61 adrenal myelolipomas confirmed by surgery and pathology was retrospectively analyzed from March 2005 to September 2010. The size of lesions, internal echo characteristics and blood flow characteristics were analyzed . Results 23 cases of adrenal lesions were diagnosed by ultrasonography in 28 lesions from March 2005 to December 2007, with a correct rate of 82.1%. Two of them were diagnosed as myelolipoma, with a correct rate of 7.1%. One missed diagnosis and 4 misdiagnosed cases. From January 2008 to September 2010, 33 lesions were diagnosed by ultrasound, and the correct rate was 90.9%. Nineteen myelolipomas were diagnosed with the correct rate of 57.6%. Three missed diagnosis and misdiagnosis. Fifty-two lesions were characterized by clear boundary and basic morphological rules, a homogeneous medium-strong echo (equivalent to the echo of the renal collecting system) inside, and no signal inside and blood flow inside. The other eight lesions showed moderately strong echoes and low echo. Conclusions Adrenal myeloid lipoma has a characteristic color Doppler ultrasonographic findings that can be used to detect lesions and to make a qualitative diagnosis of most adrenal myeloid lipomas.