肾上腺恶性肿瘤的超声诊断价值

目的 探讨超声对肾上腺恶性肿瘤的诊断价值.方法 回顾性研究21例肾上腺恶性肿瘤患者的临床及超声资料,观测肿瘤的位置、大小、形态、回声及彩色血流信号,肿瘤与周围血管、脏器的毗邻关系等.结果 21例肾上腺恶性肿瘤中,肿瘤直径最大17.0 cm,最小2.5 cm.其中肾上腺皮质腺癌10例,肾上腺恶性嗜铬细胞瘤4例,神经母细胞瘤瘤和神经节母细胞瘤4例,肾上腺血管源性肉瘤1例,恶性纤维组织细胞瘤1例,转移性黏液腺癌1例.不同病理性质的肾上腺恶性肿瘤的声像图表现有一定差异:肾上腺皮质癌检出时体积相对较大;肾上腺神经母细胞回声不均匀,瘤内有多发点状强回声且血供丰富.超声共检出肾上腺恶性肿瘤20例,漏诊1例.结论 各类肾上腺恶性肿瘤的声像图具有一定的特征性表现,超声是诊断肾上腺恶性肿瘤有效的影像学检查方法,在临床上具有实用价值.

The value of ultrasonography in the diagnosis of adrenal gland malignant tumors

Objective To evaluate the diagnostic value of ultrasonography in the adrenal gland malignant tumors.Methods Clinical and ultrasonographic manifestations were analyzed retrospectively in 21 patients with adrenal gland malignant tumors,especially about the location,size,shape,inside echo,color flow signals and the relationship with adjacent organs.Results In this group of 21 adrenal gland malignant tumors,the maximum diameter of the tumor was 17.0 cm,and the minimal diameter was 2.5 cm.There were I0 cases of adrenocortical carcinoma,4 cases of malignant pheochromocytoma,4 cases of adrenal neuroblastoma and adrenal gang- lioneuroma,1 case of malignant fibrohistiocytoma,1 case of adrenal angiogenic sarcoma,and 1 case of adrenal metastatic carcinoma. Differences in ultrasonographic appearances were found with different pathologic features in adrenal gland malignant tumors. Adrenocortical carcinoma was usually large in size,adrenal neuroblastoma was heterogeneous echoic mass with punctate hyperecho inside and rich blood supply.Twenty cases were diagnosed properly,one case of malignant pheochromocytoma was misdiagnosed. Conclusion There are some characteristic features of tdtrasonographic appearance in adrenal gland malignant tumors.Ultrasonography is an effective and valuable method in the diagnosis of adrenal gland malignant tumors.