肾上腺结核的增强CT表现特征与临床病程的相关性

目的探讨肾上腺结核的增强CT表现特征与临床病程的相关性，以提高该病的影像诊断水平。方法经临床证实的肾上腺结核30例，在CT强化图像上观察肾上腺的位置、大小、形态、密度以及强化特征，并结合临床和病理资料加以分析，采用Cochran Armitage趋势检验进行统计分析。结果肾上腺结核累及双侧共27例（90．0％），单侧3例（10．0％）。肾上腺肿块样增大13例，轻度或中度增大17例，轮廓仍保持完整。肾上腺增大密度均匀2例（6．7％），不均匀增大28例（93．3％）。周边强化16例（53．3％），钙化17例（56．7％）。经抗结核治疗后的6例复查CT示，5例双侧增大的肾上腺体积缩小或恢复正常，其内低密度消失，新出现点状钙化2例。钙化多见于临床后期，17例钙化中，病程〉12个月者10例，存在随病程增长而递增的分布趋势（x^2=7．47，P〈0．05），而周边强化则多见于临床早期，16例中有11例临床病程≤12个月，存在随病程增长而递减的分布趋势（x^2=6．60，P〈0．05）。结论肾上腺结核CT具有特征性表现，与临床病程存在一定的相关性，为临床治疗及疗效判断提供指导。     

肾上腺结核的CT诊断与鉴别诊断

目的：探讨肾上腺结核CT诊断及鉴别诊断价值。方法：回顾性分析经临床确诊的21例肾上腺结核患者的CT资料和临床资料。重点分析钙化特点与强化特点及其在鉴别诊断中的意义。21例均行CT平扫,13例同时行CT增强扫描。结果：单侧发病4例,双侧发病17例。肾上腺存在并体积增大10例,肾上腺存在并体积缩小2例,失去肾上腺正常形态9例。有钙化密度病灶15例,无钙化低密度病灶6例。全部13例增强扫描病例均出现明显边缘强化。21例中有5例误诊。结论：肾上腺结核多双侧发病,病灶边缘强化和钙化是较特征性CT表现,其程度与病程有关。     

肾上腺结核的CT诊断

指明肾上腺结核的ＣＴ表现并估价ＣＴ诊断的可能性。回顾性复习了１０例肾上腺结核的ＣＴ检查所见。ＣＴ检查，肾上腺结核依病期而有两种不同形态学复习：双肾上腺增大，内含低密度区，并呈状强化；双肾上腺部分或完全钙化。ＣＴ检查对肾上腺结核具有诊断价值，多数病例结合临床和实验室资料可获得正确诊断。     

肾上腺CT扫描诊断结核性Addison病的价值

 目的 总结Addison病肾上腺CT形态特点和诊断价值.方法 对1992～2006年临床诊断Addison病23例的肾上腺影像学特征进行回顾性分析,包括行CT平扫10例,B超13例和腹部X线检查8例,CT平扫中5例同时做B超检查.结果 (1)82.6 %(19/23)的患者临床诊断为结核性Addison病,男:女=6:13,平均42.8岁(17～72岁),其中68.4 %(13/19)有陈旧性肺结核病史;(2)10例患者行肾上腺CT平扫,结核性Addison病7例中表现干酪化期病变者5例,钙化期2例;其余3例为自身免疫性Addison病,肾上腺大小、形态和密度均正常,或萎缩,但均没有钙化灶;(3)典型干酪化期病变主要为肾上腺增大及钙化、或仅有增大或钙化;钙化期则表现为肾上腺增大伴片状或斑点状钙化;(4)超声显示干酪化期病变为肾上腺内部回声欠均匀,伴体积增大和(或)钙化;X线只能显示肾上腺区域钙化影征象.结论 CT检查有助于明确Addison病肾上腺病变的类型和分期,效果优于腹部超声和X线片检查.     

CT在前列腺癌诊断及分期中的价值

目的：探讨CT用于前列腺诊断及分期的价值。方法：回顾分析40例前列腺癌（24例经病理或细胞学证实，16例经临床证实）的CT征象，进行CT分期，12例行MPR重建，参照J-W标准对比CT分期与临床分期，结果：40例前列腺癌，CT表现前列腺正常2例，增大38例；前列腺内局限性病灶17例，病灶结节状，肿块状外突23例；病灶平扫低/低混密度27例（67.5%)/3例（7.5%)，平扫等密度，增强后为低密度10例（25%0；钙化13例，侵及精囊腺，膀胱，直肠，盆腔淋巴结及远处转移各11例，19例，9例、5例、6例，CT复合征象23例（57.5%)。CT分期的总准确率为82.5%,C、D期符合率为90%和66.7%,区分A/B期和C/D期的敏感性90%。结论：CT复合征象对前列腺癌的诊断有较高的特异性。结合3D-MPR有助于定位诊断，CT能较准确的区分A/B期和C/D期肿瘤，对C、D期肿瘤诊断准确性较高。     

高血压病Ⅱ期肾上腺形态的改变

我们对52例高血压病Ⅱ期患者和30名健康人进行肾上腺CT扫描，以对比观察肾上腺形态的异常改变，探讨原发性高血压病正期与肾上腺形态的关系。1对象和方法1．1对象按世界卫生组织（WHO）标准，选高血压病Ⅱ期患者52例，均为我院门诊和住院病人，作为高血压病组；其中男21例，女31例；年龄27～56岁，平均47±4．7岁；病程1～15年；Ⅱ级以上眼底变化43例；X线示左室扩大25例；心电图示左室肥厚、心肌受损28例；尿蛋白土～＋15例；肾功能均正常；全部病例经血游离皮质醇、尿儿条酚胺、醛固用及其它有关生化检查除外库欣综合征、嗜铬细胞瘤及…     

Addison病的CT诊断和分型

目的：探讨ＣＴ对各型Ａｄｄｉｓｏｎ病的诊断价值。材料与方法：根据临床表现，实验室检查和ＣＴ检查对３４例，Ａｄｄｉｓｏｎ病进行了分类，其中结核性２４例，自身免疫性１０例，对肾上腺区域进行非增强薄层ＣＴ扫描，结果：结核性Ａｄｄｉｓｏｎ病中，６３％有肾上腺钙化（其中病程长２年者为１００％，病程短于２年者为３６％）７９％肾上腺增大（其中病理长于２年者为５０％，病程短于２年者为１００％），自身免疫性Ａｄｄｉ     

肾上腺结核致Addison病的CT表现及其与临床病程的关系

目的探讨不同病程的肾上腺结核致Addison病的CT表现及与临床病程的关系。方法回顾性分析21例经临床证实的肾上腺结核的CT表现及与临床病程的关系。结果 21例患者均双侧肾上腺受累(100%),其中表现为肾上腺增大共16例32个病灶(32/42,76.2%),表现为肾上腺萎缩5例10个病灶(10/42,23.8%)。32个增大的肾上腺中,16个(16/32,50%)失去原有的轮廓而表现为肿块型,16个(16/32,50%)保持原有的轮廓,24个(24/32,75%)肾上腺呈周边环形强化,8个(8/32,25%)肾上腺呈不均匀强化。肾上腺病灶大小在1.2～6.7cm,平均(2.5±1.8)cm。钙化出现在23个病灶(23/42,57.1%)。随着肾上腺Addison病的临床病程增长,病灶逐渐变小,出现钙化及保持正常肾上腺轮廓的概率增加,而周边环形强化出现的概率下降。结论肾上腺结核具有较特征性的CT表现,且CT表现与Addison病的临床病程长短相关。     

腹膜结核的CT表现对比分析及其鉴别诊断

目的：探讨CT对腹膜结核及腹膜转移癌和细菌性腹膜炎的诊断及其鉴别诊断价值。方法：回顾性分析17例经病理证实的腹膜结核（组A）、20例炎性腹腔积液（组B）和11例腹膜转移癌（组C）的影像资料,对照分析3组病例的CT表现,重点分析各组腹腔积液的密度、分布特点以及肠系膜、大网膜、腹膜增厚的形态学特点,并总结腹膜结核的CT表现,结合文献讨论其鉴别诊断。结果：腹膜结核组与腹膜炎组在大网膜、肠系膜形态改变的上差异有显著性意义（P〈0.05）;腹膜结核组与转移癌组在腹腔积水范围和腹膜增厚的形态上差异有显著性意义（P〈0.05）。结论：大多数腹膜结核CT表现为较有特征的腹膜钙化和腹膜轻度均匀增厚,结合临床可与细菌性腹膜炎、腹膜转移瘤鉴别。     

节细胞神经瘤的CT及MRI表现

【摘要】目的：探讨节细胞神经瘤的CT及MRI表现，旨在提高对该病的影像诊断水平。方法：搜集43例经手术病理证实的节细胞神经瘤的临床及影像资料，患者术前行CT或MRI平扫及多期增强扫描，结合文献回顾性分析其影像特征。结果：后纵隔脊柱旁19例（右侧14例，左侧5例）；肾上腺10例（右侧7例，左侧3例）；椎管内外多发6例，其中3例合并Ⅰ型神经纤维瘤病；1例合并Ⅱ型神经纤维瘤病；椎管内外单发2例；腹膜后5例。43例均边界清楚，25例呈椭圆形或梭形，9例呈类圆形，9例形态不规则。22例伴有伪足或呈嵌入式生长，13例脊柱旁病灶部分嵌入椎管内，造成相应椎间孔扩大。CT平扫9例出现钙化，30例CT增强扫描，其中22例动脉期及静脉期无明显强化，5例轻度不均匀强化，3例中度强化，9例延迟期可见条片状或絮状强化。MR T1WI呈等或稍低信号，T2WI以高信号为主，其中8例可见条索状稍低信号。12例MR增强扫描，其中8例呈轻度斑片状或絮状不均匀强化，1例呈明显不均匀强化。结论：节细胞神经瘤的影像表现具有一定的特征性，若病灶位于后纵隔、腹膜后或肾上腺，边界清楚，形态规则，呈伪足或嵌入式生长，密度/信号均匀，CT可见钙化或MR见漩涡征，增强扫描条索状或絮状轻度强化，应首先考虑诊断节细胞神经瘤。     

肾上腺结核所致艾迪生病的CT表现

分析并总结活动性结核所致艾迪生病（Ａｄｄｉｓｏｎ ｄｉｓｅａｓｅ）的肾上腺ＣＴ表现。材料和方法：分析１８例经手术或随访证实的结核所致艾迪生病肾上腺ＣＴ表现。结果：本组活动性结核所致艾迪生病双侧肾上腺均受累,３５个活动性结核肾上腺增大,１个非活动性结核肾上腺萎缩并钙化。３４个（１７例）增大的肾上腺造影剂增强后内见坏死区,其中１９个肾上腺显示中央大片坏死及周边环状增强。３５个增大的肾上腺吕,２５个保持     

Addison's disease due to adrenal tuberculosis: contrast-enhanced CT features and clinical duration correlation

PURPOSE: To describe CT morphology of untreated adrenal tuberculosis during the different stages of the natural history of the disease and to evaluate the diagnostic implications of CT features. MATERIALS AND METHODS: We retrospectively evaluated CT features in 42 patients with documented adrenal tuberculosis for the location, size, morphology, and enhancement patterns shown on CT images. The clinical duration were correlated with the CT features. RESULTS: Of the 42 patients with untreated adrenal tuberculosis, bilaterally enlarged adrenal glands were revealed in 38 cases (91%), unilaterally enlarged in 3 cases (7%), and normal size in 1 case (2%). Of the 41 cases (98%) with enlargement, mass-like enlargement was seen in 20 cases (49%) and enlargement with preserved contours in 21 cases (51%). Peripheral rim enhancement presented in 22 cases (52%) on contrast-enhanced CT. Non-enhanced CT scan revealed calcification in 21 cases (50%). As the duration of Addison's disease increased, the presence of calcification and contour preservation increased concomitantly (p<0.001), whereas peripheral rim enhancement and mass-like enlargement decreased concomitantly on CT images (p<0.001). CONCLUSION: CT may be helpful in diagnosing adrenal tuberculosis when clinically suspected, and CT features are correlated to the clinical duration of Addison's disease.     

Minor morphologic abnormalities of adrenal glands at CT: prognostic importance in patients with lung cancer

PURPOSE: To determine the prognostic importance of minor morphologic abnormalities of the adrenal glands at computed tomography (CT) in patients with lung cancer. MATERIALS AND METHODS: The study was approved by the committee on human research; written informed consent was not required. The authors retrospectively identified 197 patients with lung cancer who underwent serial chest or abdominal CT and did not have a focal adrenal mass at baseline CT. Two readers independently classified the morphologic features of each adrenal gland as normal, smoothly enlarged, or nodular at initial CT examination. They separately recorded the presence or absence of metastases to the adrenal glands (ie, any new focal adrenal mass) at final CT examination; a third independent reader arbitrated when interpretations were discordant (n = 11). Multivariate Cox proportional hazard models were used to assess for associations between baseline adrenal gland morphologic features and subsequent development of adrenal metastases. RESULTS: At initial CT, reader 1 classified 253 (64%), 70 (18%), and 71 (18%) of the 394 adrenal glands and reader 2 classified 258 (65%), 45 (11%), and 91 (23%) of these glands as normal, smoothly enlarged, or nodular, respectively. The readers had moderate interobserver agreement regarding the classification of adrenal gland morphologic features (kappa = 0.54). Metastases subsequently developed in 13 adrenal glands in 11 patients. Cox proportional hazard models revealed no significant association between baseline adrenal gland morphologic features and subsequent development of adrenal metastases (P = .50 and P = .20 for readers 1 and 2, respectively). CONCLUSION: In patients with lung cancer, smooth enlargement or nodularity of the adrenal glands at baseline CT is not associated with increased risk of subsequently developing adrenal metastases.     

Evaluation of primary adrenal insufficiency secondary to tuberculous adrenalitis with computed tomography and magnetic resonance imaging: Current status

As one kind of infectious diseases of adrenal gland, adrenal tuberculosis can result in a life-threatening disorder which is called primary adrenal insufficiency (PAI) due to the destruction of adrenal cortex. Computed tomography (CT) and magnetic resonance imaging (MRI) play significant roles in the diagnosis of this etiology of PAI based on the CT and MRI appearances of the adrenal lesions. In this mini-review, we intend to study the CT and MRI features of adrenal tuberculosis, which could be helpful to both endocrinologist and radiologist to establish a definitive diagnosis for adrenal tuberculosis resulting in PAI.     

外伤性急性肾上腺损伤CT诊断

目的:探讨外伤性急性肾上腺损伤的CT表现。方法:对外伤性急性肾上腺损伤的20例患者进行CT平扫,其中加CT增强扫描12例,20例均于外伤后2～5h行CT检查;随访CT复查17例;对其CT表现作回顾性分析。结果:20例中右侧18例,左侧1例;双侧1例。3例肾上腺挫伤CT平扫表现为肾上腺肿胀、增粗、边缘凸起、密度不均;17例肾上腺血肿CT平扫呈梭形或卵圆形密度均匀增高或混杂密度。肾上腺周围脂肪囊内线条或斑片状密度增高影6例,同侧膈脚增厚2例。增强12例中,挫伤2例增强显示肾上腺增粗,均匀强化1例,不均匀强化1例。血肿10例增强显示病灶边缘呈环状强化5例,呈线状强化3例,病灶无明显强化2例。17例随访复查CT显示血肿范围缩小,密度减低,CT值较急性期减低10～20HU。结论:外伤性急性肾上腺损伤CT表具有特征性,增强扫描及CT随访有助于诊断。     

Usefulness of standardized uptake values for distinguishing adrenal glands with pheochromocytoma from normal adrenal glands by use of 6-18F-fluorodopamine PET.

6-(18)F-Fluorodopamine ((18)F-FDA) PET is a highly sensitive tool for the localization of pheochromocytoma (PHEO). The aim of this study was to establish cutoff values for pathologic and physiologic adrenal gland tracer uptake. METHODS: (18)F-FDA PET with CT coregistration was performed in 14 patients (10 men and 4 women; age [mean +/- SD], 42.9 +/- 13.3 y) with unilateral adrenal gland PHEO and in 13 control subjects (5 men and 8 women; age, 51.7 +/- 12.5 y) without PHEO. Standardized uptake values (SUVs) were compared between adrenal glands with PHEO and normal left adrenal glands in control subjects. RESULTS: (18)F-FDA accumulation was observed in all adrenal glands with PHEO and in 6 of 13 control adrenal glands (P = 0.02). The SUV was higher in adrenal glands with PHEO (mean +/- SD, 16.1 +/- 6.1) than in (18)F-FDA-positive control adrenal glands (7.7 +/- 1.4) (P = 0.005). SUV cutoffs for distinguishing between adrenal glands with PHEO and normal adrenal glands were 7.3 (100% sensitivity) and 10.1 (100% specificity). CONCLUSION: The SUVs of adrenal foci on (18)F-FDA PET facilitate the distinction between adrenal glands with PHEO and normal adrenal glands.     

拟似肺癌的肺结核螺旋CT表现特征及其手术病理发现

目的探讨误诊为肺癌的肺结核螺旋CT表现特征与手术病理所见的相关性。资料与方法搜集术前误诊为肺癌，但经手术病理证实为肺结核30例。全部病例均行螺旋CT扫描，回顾性地评价螺旋CT表现与手术及病理改变的关系。结果(1)25例CT表现为肿块或结节，其中密度不均21例，空洞12例，卫星病灶22例。20例行增强扫描，60％(12／20)呈外周部分或环状强化，40％(8／20)无明显强化。病理为上皮样细胞及纤维组织包裹干酪样物质。(2)5例表现为肺叶、段实变或不张，其中表现为叶、段实变3例，支气管狭窄伴肺不张2例。病变密度不均匀5例，多发小空洞4例，钙化灶2例，卫星病灶5例，2例病变周围有支气管扩张。病理为干酪灶与增殖结节融合。结论病变的形态、密度、强化特征以及卫星病灶、病变周围支气管扩张等螺旋CT征象有助于不典型肺结核与肺癌的鉴别。     

Computed tomographic evaluation of adrenal glands in patients with bronchogenic carcinoma

One hundred thirty-four patients with histo-pathologically proven bronchogenic carcinoma underwent computed tomography (CT) of the thorax and adrenal glands. Prospectively, 23 of the 134 patients had adrenal metastasis, based on CT criteria for enlargement of the gland. Retrospectively, however, some proved to be false positives. In addition, the diagnosis of adrenal metastasis frequently altered the initial staging and the treatment modality. We suggest that valid diagnoses of adrenal metastases on CT scan be made on the basis of altered shape as well as on altered size of the gland.