肾上腺节细胞神经瘤的MR表现与病理对照分析

目的探讨肾上腺节细胞神经瘤的MR表现,以提高对该病的认识和诊断水平。方法回顾性分析8例经手术、病理证实的肾上腺节细胞神经瘤的MR表现,并与病理结果进行对照。结果 8例肾上腺节细胞神经瘤5例位于右侧,3例位于左侧;病侧肾上腺湮灭,所有病灶边界清楚,其中6例病灶呈圆形或椭圆形,2例呈不规则形,并呈塑形生长,无周围组织和血管侵犯征像;MR主要表现为T1WI呈等强度或低信号影,T2WI呈明显不均匀高信号影,5例内见条状、片状或漩涡状低信号影,DWI呈高信号影,增强后动脉早期轻度强化,实质期、延迟期呈渐进性不均匀轻中度强化;镜下肿瘤由呈束状、漩涡状排列的神经纤维细胞和散在分布的胞浆丰富的节细胞组成,细胞间质含大量黏液基质。结论肾上腺节细胞神经瘤的MR表现具有一定特征性,与病理特点有很好的相关性,有助于与肾上腺其他病变相鉴别。

MRI characteristics of adrenal ganglioneuroma：Comparison with pathological results

Objective To explore the MRI features of adrenal ganglioneuroma for improving the diagnostic accuracy and understanding.Methods The MRI findings of 8 cases with adrenal ganglioneuroma confirmed by surgical were analyzed retrospectively and compared with pathological findings.Results Five cases were located in the right adrenal gland,and 3 cases in the left.The adrenal glands in the abnormal side were disappeared.All masses were well defined.6 cases appeared as round or oval.2 cases appeared as irregular margin,shaped without evident invasion of the surrounding tissues or vessels.The lesions displayed isointensity or hypointensity on T1WI and heterogeneous hyperintensity on T2WI.A typical whirlpool sign was seen in 5 cases on T2WI.The lesions showed hyperintensity on DWI.The slight enhancement was seen in the arterial phase and gradually more stronger enhancement during the delayed phase after contrast administration.Pathologically,the tumors were composed of many nerve fiber cells,a few of scattering or nesting mature ganglion cells and intercellular substance with a large amount mucus.Conclusion The MRI findings of adrenal ganglioneuroma have certain characteristic,which are correlated with histopathology closely,therefore can contribute to the differentiation with other adrenal disease.