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目的探讨不同病程的肾上腺结核致Addison病的CT表现及与临床病程的关系。方法回顾性分析21例经临床证实的肾上腺结核的CT表现及与临床病程的关系。结果 21例患者均双侧肾上腺受累(100%),其中表现为肾上腺增大共16例32个病灶(32/42,76.2%),表现为肾上腺萎缩5例10个病灶(10/42,23.8%)。32个增大的肾上腺中,16个(16/32,50%)失去原有的轮廓而表现为肿块型,16个(16/32,50%)保持原有的轮廓,24个(24/32,75%)肾上腺呈周边环形强化,8个(8/32,25%)肾上腺呈不均匀强化。肾上腺病灶大小在1.2～6.7cm,平均(2.5±1.8)cm。钙化出现在23个病灶(23/42,57.1%)。随着肾上腺Addison病的临床病程增长,病灶逐渐变小,出现钙化及保持正常肾上腺轮廓的概率增加,而周边环形强化出现的概率下降。结论肾上腺结核具有较特征性的CT表现,且CT表现与Addison病的临床病程长短相关。
Objective To investigate the CT manifestations of Addison’s disease caused by adrenal tuberculosis in different stages and its relationship with clinical course. Methods A retrospective analysis of 21 cases of clinically confirmed adrenal tuberculosis CT findings and the relationship between clinical course. Results Twenty-one patients had bilateral adrenal involvement (100%), of which 16 were 32 (42/42, 76.2%) with adrenal enlargement. Five lesions were found in 10 adrenal lesions (10/42, 23.8 %). Of the 32 enlarged adrenal glands, 16 (16/32, 50%) lost their original contour and presented as lumps, 16 (16/32, 50%) maintained their original contour and 24 (24 / 32,75%) showed adrenal peripheral annular enhancement, 8 (8 / 32,25%) adrenal uneven enhancement. Adrenal lesions in the size of 1.2 ~ 6.7cm, with an average (2.5 ± 1.8) cm. Calcification occurred in 23 lesions (23 / 42,57.1%). As the clinical course of Adrenal Addison’s disease increases, the lesion becomes smaller, the probability of calcification and normal adrenal contour increases, and the probability of peripheral annular enhancement decreases. Conclusion Adrenal tuberculosis has more characteristic CT manifestations, and CT findings are related to the clinical course of Addison’s disease.