肾上腺占位性病变的超声与CT诊断的对比(1)
摘要：目的 比较超声、CT检查在诊断肾上腺占位性病变中的价值。方法 将肾上腺占位32病例的超声、CT表现与手术、病理结果进行对照，分别比较超声、CT诊断肾上腺占位的敏感性和特异性。结果 32例肿块中共有13例(40.62%)肾上腺占位在超声检查时偶尔发现，CT检查偶尔发现4例(12.50%);右侧肾上腺肿块的超声定位诊断符合率94.12%，左侧肾上腺肿块的超声显示率53.33%。不同病理类型的肾上腺肿块可出现相应的超声或CT表现，部分具有特征性。结论 超声对于右侧肾上腺占位的检出率与CT一致，左侧肾上腺占位的检出率低于CT;定性诊断上超声和CT检查具有一致性，两者之间有着很好的互补性。
关键词：肾上腺占位;超声;CT;影像诊断
中图分类号：R445.1;R816.6;R586 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.05.056
, http://www.100md.com
文章编号：1006-1959(2019)05-0170-03
Abstract：Objective To compare the value of ultrasound and CT in the diagnosis of adrenal space-occupying lesions. Methods The ultrasound and CT findings of 32 cases of adrenal gland were compared with the results of surgery and pathology. The sensitivity and specificity of ultrasound and CT for the diagnosis of adrenal space were compared. Results A total of 13 (40.62%) adrenal glands in 32 cases were occasionally found during ultrasonography. Occasionally， 4 cases (12.50%) were found by CT examination. The coincidence rate of ultrasound diagnosis of right adrenal mass was 94.12% (CT was 100%). The ultrasound display rate of the left adrenal mass was 53.33% (CT was 100%). Different pathological types of adrenal masses may have corresponding ultrasound or CT findings， some of which are characteristic. Conclusion The detection rate of ultrasound on the right adrenal gland is consistent with CT. The detection rate of left adrenal space is lower than that of CT. The qualitative diagnosis is consistent with ultrasound and CT. The two have good complementarity.
, 百拇医药
Key words：Adrenal mass; ultrasonography; CT; diagnosis
腎上腺占位性病变的部位深而隐蔽，部分病例可无特异性临床表现，其临床诊断主要依赖影像学检查。近年来，影像技术的迅速发展，使得肾上腺占位性病变的检出率有了很大提高[1-4]。本文通过对肾上腺占位病例的手术、病理结果和相应超声、CT的表现及其诊断结果的分析，对超声、CT各自诊断肾上腺占位性病变的的优缺点进行比较。
1资料与方法
1.1一般资料 选取2016年1月～2018年9月在江苏省中医院行手术治疗的肾上腺肿块患者32例，男16例，女16例，年龄20～77岁。其中17例患者无明显症状，在常规体检或门诊肝胆胰脾肾超声检查时发现肾上腺占位;7例因血压高、乏力、下肢浮肿等症状行肾上腺超声检查时发现肾上腺占位;余8例虽因其他疾病做过上腹部超声检查，但未对肾上腺进行专项检查。本组病例中，在常规体检或门诊做肝胆胰脾常规超声检查时偶尔发现肾上腺占位性病变13例(40.62%)，在门诊CT检查时偶尔发现4例(12.50%)，7例有针对性地对肾上腺进行了专项超声检查，超声全部提示占位。超声显示肿块的直径0.9～10 cm;CT显示肿块的直径0.9～8 cm(图1～图3)所有病例术前均行CT及增强检查，术后有明确的病理诊断。
1.2方法
1.2.1超声检查 患者空腹状态下行常规肝、胆、胰、脾检查，所用仪器为 GE Logiq 9和 Logiq S6 超声诊断仪，探头频率3～5.2 MHz;肾上腺专项检查时，多方位多角度扫查肾上腺区，二维观察肿块部位、大小、形态、边界、有无包膜及内部回声特点，以CDFI评估血供，判断有无局部外浸和周围组织脏器的毗邻关系。, http://www.100md.com(陆倩)
关键词：肾上腺占位;超声;CT;影像诊断
中图分类号：R445.1;R816.6;R586 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.05.056
, http://www.100md.com
文章编号：1006-1959(2019)05-0170-03
Abstract：Objective To compare the value of ultrasound and CT in the diagnosis of adrenal space-occupying lesions. Methods The ultrasound and CT findings of 32 cases of adrenal gland were compared with the results of surgery and pathology. The sensitivity and specificity of ultrasound and CT for the diagnosis of adrenal space were compared. Results A total of 13 (40.62%) adrenal glands in 32 cases were occasionally found during ultrasonography. Occasionally， 4 cases (12.50%) were found by CT examination. The coincidence rate of ultrasound diagnosis of right adrenal mass was 94.12% (CT was 100%). The ultrasound display rate of the left adrenal mass was 53.33% (CT was 100%). Different pathological types of adrenal masses may have corresponding ultrasound or CT findings， some of which are characteristic. Conclusion The detection rate of ultrasound on the right adrenal gland is consistent with CT. The detection rate of left adrenal space is lower than that of CT. The qualitative diagnosis is consistent with ultrasound and CT. The two have good complementarity.
, 百拇医药
Key words：Adrenal mass; ultrasonography; CT; diagnosis
腎上腺占位性病变的部位深而隐蔽，部分病例可无特异性临床表现，其临床诊断主要依赖影像学检查。近年来，影像技术的迅速发展，使得肾上腺占位性病变的检出率有了很大提高[1-4]。本文通过对肾上腺占位病例的手术、病理结果和相应超声、CT的表现及其诊断结果的分析，对超声、CT各自诊断肾上腺占位性病变的的优缺点进行比较。
1资料与方法
1.1一般资料 选取2016年1月～2018年9月在江苏省中医院行手术治疗的肾上腺肿块患者32例，男16例，女16例，年龄20～77岁。其中17例患者无明显症状，在常规体检或门诊肝胆胰脾肾超声检查时发现肾上腺占位;7例因血压高、乏力、下肢浮肿等症状行肾上腺超声检查时发现肾上腺占位;余8例虽因其他疾病做过上腹部超声检查，但未对肾上腺进行专项检查。本组病例中，在常规体检或门诊做肝胆胰脾常规超声检查时偶尔发现肾上腺占位性病变13例(40.62%)，在门诊CT检查时偶尔发现4例(12.50%)，7例有针对性地对肾上腺进行了专项超声检查，超声全部提示占位。超声显示肿块的直径0.9～10 cm;CT显示肿块的直径0.9～8 cm(图1～图3)所有病例术前均行CT及增强检查，术后有明确的病理诊断。
1.2方法
1.2.1超声检查 患者空腹状态下行常规肝、胆、胰、脾检查，所用仪器为 GE Logiq 9和 Logiq S6 超声诊断仪，探头频率3～5.2 MHz;肾上腺专项检查时，多方位多角度扫查肾上腺区，二维观察肿块部位、大小、形态、边界、有无包膜及内部回声特点，以CDFI评估血供，判断有无局部外浸和周围组织脏器的毗邻关系。, http://www.100md.com(陆倩)