Cyteval C, Pradel J, Pujol J, Krempf M, Lamarque J L, Jaffiol C, Peltier P, Chatal J F, Charbonnel B
Département d'Imagerie Médicale, Hôpital Lapeyronie, Montpellier.
Ann Endocrinol (Paris). 1990;51(3-4):161-72.
Currently, the major method of adrenal gland imaging is computed tomography. This method allows demonstration of normal adrenals and the diagnosis of adrenal masses (if these are greater than 1 cm in diameter). The examination should be directed by clinical signs and known laboratory investigations. Computed tomography is therefore the first line investigation to perform. Certain lesions may be better demonstrated by other methods: MRI and MIBG scintigraphy offer a greater specificity in the investigation of pheochromocytomas. In addition, scintigraphy can identify possible ectopic tumours or recurrences. Selective catheterisation of the adrenal veins allows aldosterone and cortisone secretions to be assayed. There remains the problem of the incidental finding of adrenal masses in either an asymptomatic patient or in the context of investigation of spread of a know cancer. These lesions may benefit from diagnostic percutaneous guided biopsy.
目前,肾上腺成像的主要方法是计算机断层扫描。这种方法能够显示正常肾上腺,并诊断肾上腺肿块(如果直径大于1厘米)。检查应由临床体征和已知的实验室检查来指导。因此,计算机断层扫描是首先要进行的检查。某些病变可能用其他方法显示得更好:磁共振成像(MRI)和间碘苄胍(MIBG)闪烁扫描在嗜铬细胞瘤的检查中具有更高的特异性。此外,闪烁扫描可以识别可能的异位肿瘤或复发情况。肾上腺静脉选择性插管可用于检测醛固酮和皮质醇的分泌。无论是无症状患者还是在已知癌症转移的检查中,偶然发现肾上腺肿块的问题仍然存在。这些病变可能受益于经皮引导下诊断性活检。