| 赵小英,李志洁,宋建,等.肾上腺节细胞神经瘤多排螺旋 CT诊断价值[J].安徽医药,2020,24(6):1177-1180. |
| 肾上腺节细胞神经瘤多排螺旋 CT诊断价值 |
| Diagnostic value of multi?detector spiral CT in adrenal ganglion neuroma |
| |
| DOI：10.3969/j.issn.1009?6469.2020.06.029 |
| 中文关键词: 肾上腺肿瘤/外科学 肾上腺切除术 腹腔镜检查 体层摄影术， X线计算机 误诊 机器人 |
| 英文关键词: Adrenal gland neoplasms/surgery Adrenalectomy Laparoscopy Tomography,X?ray computed Diagnostic errors Robotics |
| 基金项目: |
|
| 摘要点击次数: 1697 |
| 全文下载次数: 714 |
| 中文摘要: |
| 目的总结肾上腺节细胞神经瘤的发病特点、多排螺旋 CT(MDCT)表现、病理及治疗方法，以提高对该病的诊治水平。方法回顾性分析 2016年 3月至 2018年 1月安徽医科大学第一附属医院确诊的 6例肾上腺节细胞神经瘤病人临床资料，男性 5例，女性 1例。 1例为突发腹痛半天， 5例无明显临床症状。 6例中 1例接受 CT平扫，其余 5例接受 CT平扫及增强扫描。 6例病人在全麻下进行腹腔镜或机器人腹腔镜手术肾上腺占位切除治疗。结果 CT平扫时密度均匀或伴有斑点状钙化影，边界清晰，张力较低，沿组织间隙生长， CT值约 10～20 HU，5例行增强扫描肿瘤呈轻度渐进性强化。病人内分泌检查均无异常。术前诊断正确 2例，误诊 4例。 6例病人均手术顺利，术中出血少，切口愈合佳，痊愈出院。病理诊断:肾上腺节细胞神经瘤。术后随访无复发。结论肾上腺节细胞神经瘤临床罕见，CT表现具有一定特征性，易误诊。病人通常无明显临床症状， “伪足征”及轻度渐进性强化是其特征性表现，对其特征性的把握有助于术前正确诊断及制定手术方案。病理学检查为确诊依据。腹腔镜下肿瘤切除是目前临床上主要治疗方法，对于复杂病例或需要保留肾上腺的病人可行机器人腹腔镜治疗 |
| 英文摘要: |
| Objective To increase the diagnosis and treatment of adrenal ganglion neuroma by means of summarizing the incidence characteristics，multi?detector spiral CT(MDCT)findings，pathology and treatment of the disease.Methods Six patients from TheFirst Affiliated Hospital of Anhui Medical University from March 2016 to January 2018 with adrenal ganglioneuroma were retro?spectively analyzed.There were 5 males and 1 female.One patient with half a day history of sudden abdominal pain，and the 5 pa? tients had no significant clinical symptoms.One of the 6 patients only underwent CT plain scan，and the remaining 5 patients alsounderwent CT enhanced scan.All patients took laparoscopic or robotic laparoscopic surgery for adrenal mass resection under gener?al anesthesia.Results The CT scan was uniform in density or accompanied by speckled calcification，with clear boundary，low ten? sion，growth along the interstitial space，CT value was about 10?20 HU，and 5 cases of enhanced scanning tumor showed mild pro? gressive enhancement.None of the patients’endocrine examination was abnormal.2 cases were diagnosed correctly before operationand 4 cases were misdiagnosed.Operations of all the 6 patients were successful，with little intraoperative blood loss and the inci? sions healed well，and were discharged.Pathological diagnosis was adrenal ganglion cell neuroma.No recurrence after the follow?up. Conclusions Adrenal ganglion cell neuroma is rarely occurred in clinical practice and misdiagnosed easily.The patient usuallyhas no significant clinical symptoms，but CT scan manifests certain characteristics.The "pseudopodia sign" and mild progressive en?hancement are characteristic manifestations.It is helpful for increasing correct diagnosis before surgery and making surgical plan.Pathological examination is the basis for diagnosis.Laparoscopic tumor resection is the main clinical treatment currently.Robotic lap?aroscopic treatment is feasible for patients with complicated cases or those who need to preserve the adrenal gland. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
