Schieda Nicola, Siegelman Evan S
1 Department of Radiology, The Ottawa Hospital, The University of Ottawa, 1053 Carling Ave, Civic Campus C1, Ottawa, ON K1Y 4E9, Canada.
2 Department of Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA.
AJR Am J Roentgenol. 2017 Jun;208(6):1206-1217. doi: 10.2214/AJR.16.17758. Epub 2017 Feb 22.
The objective of this article is to review the current role of CT and MRI for the characterization of adrenal nodules.
Unenhanced CT and chemical-shift MRI have high specificity for lipid-rich adenomas. Dual-energy CT provides comparable to slightly lower sensitivity for the diagnosis of lipid-rich adenomas but may improve characterization of lipid-poor adenomas. Nonadenomas containing intracellular lipid pose an imaging challenge; however, nonadenomas that contain lipid may be potentially diagnosed using other imaging features. Multiphase adrenal washout CT can be used to differentiate lipid-poor adenomas from metastases but is limited for the diagnosis of hypervascular malignancies and pheochromocytoma.
本文的目的是综述CT和MRI在肾上腺结节特征描述方面的当前作用。
平扫CT和化学位移MRI对富含脂质的腺瘤具有高特异性。双能CT对富含脂质腺瘤的诊断敏感性与之相当或略低,但可能改善对脂质含量少的腺瘤的特征描述。含有细胞内脂质的非腺瘤构成影像学挑战;然而,含有脂质的非腺瘤可利用其他影像学特征进行潜在诊断。多期肾上腺洗脱CT可用于鉴别脂质含量少的腺瘤与转移瘤,但在诊断富血供恶性肿瘤和嗜铬细胞瘤方面存在局限性。