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中国防痨杂志 ›› 2012, Vol. 34 ›› Issue (04): 212-215.

• 论著 • 上一篇    下一篇

肾上腺结核的多层螺旋CT诊断

塔西甫拉提·阿吾提 古丽娜·阿扎提 刘文亚   

  1. 830054  乌鲁木齐,新疆医科大学第一附属医院影像中心CT室
  • 收稿日期:2011-11-21 出版日期:2012-04-10 发布日期:2012-06-14
  • 通信作者: 刘文亚 E-mail:Wenyaliu2002@yahoo.com.cn

Multislice spiral CT diagnosis of adrenal tuberculosis

Taxifulati·Awuti,Gulina·Azhati,LIU Wen-ya   

  1. Imaging Center of First Affiliated Hospital,Xinjiang Medical University,Urumqi  830054,China
  • Received:2011-11-21 Online:2012-04-10 Published:2012-06-14
  • Contact: LIU Wen-ya E-mail:Wenyaliu2002@yahoo.com.cn

摘要: 目的  探讨肾上腺结核的多层螺旋CT平扫及增强表现特征,以提高该病的CT诊断水平。 方法  对经临床证实的13例肾上腺结核患者的CT表现特征进行回顾性分析。 结果  13例中,男性8例,女性5例;年龄20~58岁,平均42岁。肾上腺结核累及双侧共12例,单侧1例。肾上腺肿块样增大10例,轻度或中度增大3例,轮廓完整。肾上腺密度均匀增高1例,不均匀增高12例。周边强化11例。4例患者经抗结核治疗后复查CT,其中1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,9例患者行手术治疗,而且术前术后进行了抗结核治疗。早期肾上腺结核 CT 表现为肾上腺体积增大,并见密度不均匀的扁圆形肿块9例,增强扫描后肿块周边强化,其内见线样明显强化的正常肾上腺组织分隔,边缘清楚。晚期肾上腺结核表现为腺体萎缩及钙化4例。8例患者伴有肾上腺外结核,包括肺结核4例、泌尿系结核2例、脊柱结核1例,同时伴有肺结核、左肾结核及脊柱结核1例。 结论  肾上腺结核的CT具有特征性表现,当发现全身多脏器结核,同时发现肾上腺上述影像变化,则要考虑肾上腺结核的诊断,为临床治疗及疗效判断提供指导。

关键词: 肾上腺疾病, 结核, 内分泌系统/放射摄影术, 体层摄影术, 螺旋计算机

Abstract: Objective  To explore the multi-slice spiral CT (MSCT) features of adrenal tuberculosis in order to improve the CT diagnosis level.  Methods  The MSCT findings of 13 patients with adrenal tuberculosis were retrospectively analyzed.  Results  Patients characteristics:  13 patients, 8 male and 5 femal; age range from 20 to 58 years; mean age 42 years. The CT findings: bilateral adrenal tuberculosis in 12 patients, unilateral in 1 case; mass-like increase of adrenal in 10 cases, mild or moderate increase in 3 cases with intact contours; adrenal glands enlargement with uniform density in 1 case, non-uniform enlargement in 12 cases; peripheral enhancement in 11 cases. After treatment,  CT scan showed that the size of bilateral adrenal glands in 1 case shrunk or returned to normal and the low-density disappeared. Nine patients received anti-TB treatment before and after surgery. Enlargement of adrenal glands and the uneven density of the flat circular mass were the features of 9 early adrenal tuberculosis cases with peripheral enhancement and marked enhancement of its internal lines and clear edge. Advanced adrenal tuberculosis of 4 cases showed atrophy of glands and calcification. Eight patients had extra-adrenal  tuberculosis, including lung(4 cases), urinary (2 cases), spinal tuberculosis(1 cases) and involement with pulmonary, left kidney, and spinal (1 case).  Conclusion  The MSCT findings of adrenal tuberculosis are typical. If the adrenal changes present  in patients with multi-organ tuberculosis should be considered the diagnosis of adrenal tuberculosis which will provide a guidence for treatment and  efficacy evaluation in clinical.

Key words: Adrenal gland diseases, Tuberculosis,endocrine/radiography, Tomography,spiral computed