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目的分析肾上腺囊性病变(ACL)的CT和MRI表现,提高对该病的认识和影像诊断水平。方法回顾性分析40例经手术病理证实的ACL的CT和MRI表现。32例行CT平扫,其中24例行增强扫描;3例行MRI平扫,其中2例行增强扫描;5例同时行CT和MRI扫描。结果非肿瘤性ACL 20例,其中内皮性囊肿8例,非肿瘤性假性囊肿7例,囊性淋巴管瘤2例,畸胎瘤1例,肾上腺血肿2例;肿瘤性20例,其中嗜铬细胞瘤9例,皮质腺瘤2例,皮质腺癌2例,神经母细胞瘤1例,神经纤维瘤2例,肾上腺转移瘤4例。ACL的大小、形态、囊壁(厚度、有无壁结节)、密度或信号、强化程度和方式等特征有助于非肿瘤性、(良性与恶性)肿瘤性囊性病变的鉴别。结论部分ACL的CT、MRI表现具有一定特点,术前可做出正确诊断,为临床治疗方案的选择及预后判断提供理论依据。
Objective To analyze the CT and MRI findings of adrenal cystic lesions (ACLs) and to improve their understanding of the disease and imaging diagnosis. Methods The CT and MRI findings of 40 patients with pathologically confirmed ACL were retrospectively analyzed. Twenty-two patients underwent CT scan, of which 24 patients underwent enhanced scan. Three patients underwent MRI scan, of which 2 underwent enhanced scan and 5 underwent both CT and MRI scan. Results 20 cases of non-neoplastic ACL, of which 8 cases of endothelial cysts, 7 cases of non-tumor pseudocyst, 2 cases of cystic lymphangioma, 1 case of teratoma, 2 cases of adrenal hematoma; 20 cases of neoplastic 9 cases of chromocytoma, 2 cases of cortical adenoma, 2 cases of cortical adenocarcinoma, neuroblastoma in 1 case, neurofibroma in 2 cases, adrenal metastases in 4 cases. The size, shape, wall of the ACL (thickness, presence or absence of wall nodules), density or signal, degree of enhancement, and pattern contribute to the identification of non-neoplastic, benign and malignant neoplastic cystic lesions. Conclusion The CT and MRI manifestations of some ACLs have certain characteristics. Correct diagnosis can be made preoperatively, providing a theoretical basis for the selection of clinical treatment options and prognosis.