Szolar D H, Schmidt-Kloiber C, Preidler K W
Department of Radiology, University Hospital, Graz, Austria.
Curr Opin Urol. 1999 Mar;9(2):143-51. doi: 10.1097/00042307-199903000-00009.
Computed tomography is the first line modality in the evaluation of patients with adrenal gland masses, and has the potential to be very accurate in the localization of adrenal gland masses in patients with diseases associated with hyperfunctioning conditions of the adrenal gland. Computed tomography allows a specific diagnosis of acute adrenal haemorrhage, adrenal myelolipoma, and adrenal cysts. It is also helpful in the assessment of patients with Addison's disease, particularly the subacute form secondary to granulomatous diseases. Quantitative evaluation of adrenal masses on unenhanced or delayed-enhanced computed tomography has been shown to be highly accurate in distinguishing adrenal adenomas from non-adenomas. Attenuation of 18 HU or less on unenhanced computed tomography scans indicates adenoma with a high specificity and acceptable sensitivity. On delayed-enhanced computed tomography scans, adrenal adenomas exhibit a greater washout of contrast material than do adrenal non-adenomas. Therefore, adrenal non-adenomas have significantly higher attenuation than adenomas on delayed-enhanced computed tomography scans obtained at arbitrarily chosen times (3-60 min) after the initiation of contrast material administration.
计算机断层扫描是评估肾上腺肿块患者的一线检查方法，对于肾上腺功能亢进相关疾病患者肾上腺肿块的定位，它有潜力做到非常准确。计算机断层扫描能够对急性肾上腺出血、肾上腺髓质脂肪瘤和肾上腺囊肿做出明确诊断。它对于艾迪生病患者的评估也有帮助，特别是继发于肉芽肿性疾病的亚急性型。在平扫或延迟增强计算机断层扫描上对肾上腺肿块进行定量评估，已被证明在区分肾上腺腺瘤与非腺瘤方面具有很高的准确性。平扫计算机断层扫描上衰减值为18HU或更低提示腺瘤，特异性高且敏感性可接受。在延迟增强计算机断层扫描上，肾上腺腺瘤对比剂的廓清比肾上腺非腺瘤更明显。因此，在注射对比剂后任意选定时间（3 - 60分钟）进行的延迟增强计算机断层扫描上，肾上腺非腺瘤的衰减值显著高于腺瘤。
