| 摘要: |
| 目的分析肾上腺腺瘤超声造影增强模式，提高诊断水平。方法 经手术病理证实的33例肾上腺腺瘤患者，均经常规超声和超声造影检查，回顾性分析常见及少见的超声造影增强模式。结果33例肾上腺腺瘤常见的常规超声均表现为是单侧，最大径<4 cm，31例常规超声表现为低回声且回声均匀，1例伴囊变，1例回声不均匀；26例最大径<4cm；32例彩色多普勒超声成像（Colour Doppler flow imaging，CDFI）无血流信号；超声造影表现：增强均匀（31例），增强不均匀（2例）；稍低-等增强（26例），稀疏充填（5例），高增强（2例）；整体增强（29例），由周边向中央增强（4例）。为均匀，稍低-等的整体增强。少见的常规超声表现包括最大径≥4 cm，1例伴囊变，1例回声不均匀；超声造影表现：5例呈稀疏充填；2例呈高增强；4例增强方式由周边向中央；2例增强不均匀（1例伴囊变）。 结论 肾上腺腺瘤超声造影的常见表现为均匀、稍低-等的整体增强，少见表现包括稀疏充填、高增强、周围向中央增强、增强不均匀。根据超声造影表现大多可作出诊断或排除恶性；少数增强方式为周边向中央及增强不均匀的病例须结合增强CT或穿刺等检查排除恶性。 |
| 关键词: 超声检查 造影剂 肾上腺腺瘤 增强模式 |
| DOI： |
| 投稿时间：2018-05-02修订日期：2018-05-21 |
| 基金项目:国家自然科学基金(81771838) |
|
| Contrast- enhanced ultrasonography features of adrenal cortical adenoma |
| HE Yingqian,DU Lianfang |
| (Shanghai General Hospital) |
| Abstract: |
| Objective To investigate the enhancement pattern of adrenal cortical adenoma(ACA), and evaluate the common and uncommon contrast-enhanced ultrasonography(CEUS) features to improve the diagnostic accuracy. Methods 33 cases of histologically proved ACA were underwent conventional ultrasound and CEUS. The enhancement patterns were analyzed. Results 33 cases were unilateral and single lesion. 31 cases were hypoechoic, homogeneous echogenicity. 1 case presented heterogenous echogenicity and 1 case was with cystis changes. The maximal diameter of 26 cases <4 cm. No blood flow signal was found in 32 lesions. All cases had CEUS. 31 lesions were homogeneous enhanced and 2 cases were heterogenous. 26 masses exhibited slightly low or same peek intensity to surrounding liver or renal parenchyma. 5 cases presented no recordable contrast enhancement and 2 cases were remarkable enhanced. 29 lesions had nonspecific enhancement and 4 cases had peripheral to central contrast filling. Conclusion The common enhancement pattern of ACA was homogeneous with slightly low or same peek intensity to surrounding liver or renal parenchyma. The uncommon ACA features of CEUS included no recordable contrast enhancement, remarkable enhancement, centrpetal fill-in and heterogenous. Identification of the common CEUS enhancement patterns could improve the diagnostic ability of ACA. The diagnosis is difficult when the lesions enhanced in the pattern of centrpetal fill-in or heterogenous and still requires enhanced CT or biopsy. |
| Key words: Ultrasonography Contrast agent Adrenal cortical adenoma Ehancement pattern |
