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目的探讨肾上腺神经鞘瘤的临床特点、CT表现与肾上腺乏脂性皮质腺瘤的差异,提高对肾上腺神经鞘瘤的诊断水平。方法回顾性分析经手术病理证实的14例肾上腺神经鞘瘤和51例肾上腺乏脂性皮质腺瘤患者的CT表现,包括肿瘤部位、形态、大小、密度、边缘、钙化、囊变及强化方式等特点。结果高血压病史或血压升高症状,神经鞘瘤较乏脂腺瘤更少见(P=0.001)。病灶最长径神经鞘瘤普遍大于乏脂腺瘤(P<0.001),而且神经鞘瘤最长径多≥5 cm(P<0.001)。平扫肾上腺神经鞘瘤密度与乏脂腺瘤相比更加不均匀(P=0.028),且平扫CT值神经鞘瘤高于乏脂腺瘤(P<0.001),而动、静脉期神经鞘瘤强化值均低于乏脂腺瘤(P均<0.001)。神经鞘瘤强化程度较乏脂腺瘤低(P=0.008),而神经鞘瘤囊变较乏脂腺瘤更常见(P<0.001)。结论肾上腺神经鞘瘤的CT表现有一定的特征性,与乏脂腺瘤有差异。
Objective To investigate the clinical characteristics of adrenal schwannoma, CT findings and adrenal insufficiency cortical adenoma differences and improve the diagnosis of adrenal schwannoma. Methods The CT findings of 14 adrenal schwannoma and 51 adrenal insufficiency adrenal cortical adenomas confirmed by surgery and pathology were retrospectively analyzed. The CT features of tumor including location, shape, size, density, margin, calcification, cystic degeneration and enhancement were retrospectively analyzed . Results The history of hypertension or symptoms of elevated blood pressure was less common in Schwannoma than in those without lipomas (P = 0.001). The longest diameter of the sheath schwannoma was generally greater than that of the liposarcoma (P <0.001), and the longest diameter of schwannoma was ≥5 cm (P <0.001). The density of adrenal schwannoma was more inhomogeneous (P = 0.028) compared with that of laparotomy (P = 0.028), and the CT value of schwannoma was higher than that of laryngocarcinoma (P <0.001) Tumor enhancement values were lower than those in patients with dyslipidemia (all P <0.001). Schwannoma was less intense than liposarcoma (P = 0.008), whereas schwannomas were more common than lipophilic adenomas (P <0.001). Conclusion The CT findings of adrenal schwannoma have some characteristics, which are different from those of laparotomy.