论文部分内容阅读
目的探讨直径在4.0cm以上肾上腺皮质大腺瘤的常规MRI及扩散加权成像(DWI)表现,以提高诊断水平。方法回顾性分析经手术病理证实的15例肾上腺皮质腺瘤(≥4cm)的常规MRI表现、DWI特点及病理学表现,并与其他肿瘤进行鉴别。结果常规MRI表现:15例中,12例信号不均匀,T2WI压脂像以等高或较高信号为主,6例在梯度回波反相位上瘤体内见斑片状局灶性的信号减低区,3例在T1WI预扫见斑片状高信号区,增强扫描7例(约46.7%)呈“慢进不出”型,5例(约33.3%)呈“慢进快出”型;2例(约13.3%)呈“快进慢出”型,1例呈延迟期明显强化。实质期或延迟期肿瘤均见环形强化的完整包膜,8例见强化的纤维分隔。DWI特点:肿瘤实质扩散受限,DWI上呈高信号,表观弥散系数(ADC)图上呈低信号,平均ADC值为0.993×10-3 mm2/s,低于大多数肾上腺良性肿瘤。结论肾上腺皮质大腺瘤的病理成分复杂多样,结合其常规MRI表现和DWI特点有助于其术前定性诊断及鉴别诊断。
Objective To investigate the conventional MRI and diffusion-weighted imaging (DWI) of adrenal macular adenoma with diameter above 4.0cm in order to improve the diagnostic level. Methods Retrospective analysis of 15 cases of adrenocortical adenoma (≥ 4 cm) confirmed by surgery and pathology showed the features of conventional MRI and pathology, and were differentiated from other tumors. Results Conventional MRI showed that in 12 of 15 cases, the signal was not uniform, the signal of T2WI was dominated by high or high signal, and in 6 cases, the focal patchy signal was found in the tumor on the opposite phase of gradient echocardiography In 3 cases, patchy hyperintensities were seen in T1WI pre-scan. Seven cases (46.7%) underwent enhanced scan, and 5 cases (about 33.3%) were slow-moving fast 2 cases (about 13.3%) showed “fast forward and slow out” type, and 1 showed a marked enhancement with a delay period. Real or delayed tumor were ring enhanced complete en bloc, 8 cases, see enhanced fiber separation. DWI features: limited diffusion of tumor, high signal on DWI and low signal on apparent diffusion coefficient (ADC) map, with an average ADC value of 0.993 × 10-3 mm2 / s, which is lower than most benign adrenal tumors. Conclusions The pathological components of adrenocortical macroscopia are complex and diverse. Combining their MRI features and features of DWI is helpful for their preoperative diagnosis and differential diagnosis.