多层螺旋CT对肾上腺结核的诊断价值

发布时间：2018-08-27 13:34

【摘要】：目的探讨多层螺旋CT扫描在肾上腺结核诊治中的应用价值,以提高该病的影像诊断水平。方法回顾性分析经临床确诊的35例肾上腺结核患者的CT表现及临床资料,其中31例有明确的其他部位活动性结核或结核病史。35例均行CT平扫,26例加做CT增强扫描。结果 35病例中,双侧受累28例(80%),单侧受累7例(20%)。病变形态呈普大型17例,结节型4例,肿块型14例。病灶直径5~86 mm不等。病灶边缘模糊者25例(71.4%),边缘清晰者10例(28.6%)。病灶中有钙化密度者21例(60%),无钙化密度者14例(40%)。35例中26例行增强扫描,病灶呈周边环形强化14例(53.8%),不均匀轻度强化5例(19.2%),无强化7例(26.9%)。CT误诊6例,其中误诊为肾上腺腺瘤3例,误诊为肾上腺增生2例,误诊为转移瘤1例。35例CT扫描图像所及范围有20例同时显示合并有其他部位结核。10例在抗结核治疗后行CT扫描复查:6例病灶有好转缩小,其中有2例新出现钙化灶;3例无变化;1例病灶增多增大。结论肾上腺结核的MSCT表现具有一定的特征性,且与临床病程存在较明显的相关性,对该病的诊断及治疗均具有重要的应用价值。
[Abstract]:Objective to evaluate the value of multislice spiral CT scan in diagnosis and treatment of adrenal tuberculosis. Methods the CT findings and clinical data of 35 patients with adrenal tuberculosis were retrospectively analyzed. Among them, 31 cases had definite history of active tuberculosis or tuberculosis in other parts. 26 cases underwent plain CT scan and 26 cases underwent CT enhanced scan. Results in 35 cases, bilateral involvement was found in 28 cases (80%) and unilateral involvement in 7 cases (20%). There were 17 cases of large lesion, 4 cases of nodular type and 14 cases of mass type. The lesion diameter ranged from 5 to 86 mm. The edge of lesion was blurred in 25 cases (71.4%) and clear in 10 cases (28.6%). Among the lesions, 21 cases (60%) had calcification density, 14 cases (40%) had no calcification density, 26 cases had enhanced scan, 14 cases (53.8%) had circumferential enhancement, 5 cases (19.2%) had uneven slight enhancement, 6 cases (26.9%) were misdiagnosed with CT, among which 3 cases were misdiagnosed as adrenal adenoma, 3 cases were misdiagnosed as adrenal adenoma, and 6 cases were misdiagnosed as adrenal adenoma. 2 cases were misdiagnosed as adrenal hyperplasia, 1 case was misdiagnosed as metastatic tumor, and 20 cases were misdiagnosed as metastatic tumor. 20 cases were found to be complicated with tuberculosis at other sites. 10 cases were examined by CT scan after anti-tuberculosis treatment. Of them, 2 cases had new calcification, 3 cases had no change and 1 case had increased and enlarged. Conclusion the MSCT findings of adrenal tuberculosis have some characteristics and have obvious correlation with the clinical course of disease. It has important application value in diagnosis and treatment of adrenal tuberculosis.
【作者单位】：解放军第三零九医院放射科;
【分类号】：R529.0;R816.6

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