Schürmeyer T, Dralle H, Schuppert F, von zur Mühlen A
Klinisch-Endokrinologischen Abteilung, Medizinische Hochschule Hannover, BRD.
Acta Med Austriaca. 1988;15(4):106-8.
A retrospective analysis of clinical laboratory and imaging diagnostic criteria of pheochromocytoma was performed over a period of 2 years in 80 patients (17 with surgically proven pheochromocytomas) and yielded the following results: Clinical symptoms are not very characteristic and do not allow the diagnosis. The best diagnostic criterian was the determination of the excretion of norepinephrine and especially of epinephrine in repeated urine samples (90% correct positive, 5% false positive). The diagnostic value of plasma catecholamine concentrations is less because of a wide scatter in both, healthy subjects and patients with pheochromocytoma. The determination of dopamin as well as the clonidintest do not seem to be helpful in the diagnosis. More than 90% of our pheochromocytomas are detected by sonography or computer tomography. The MiBG scans seem to be helpful with, however, some false negative cares.
对80例患者(17例经手术证实为嗜铬细胞瘤)进行了为期2年的嗜铬细胞瘤临床实验室及影像学诊断标准的回顾性分析,结果如下:临床症状不太具有特异性,无法据此做出诊断。最佳诊断标准是测定多次尿液样本中去甲肾上腺素尤其是肾上腺素的排泄量(正确阳性率90%,假阳性率5%)。由于健康人和嗜铬细胞瘤患者的血浆儿茶酚胺浓度均有较大离散度,因此其诊断价值较小。多巴胺测定以及可乐定试验在诊断中似乎并无帮助。我们超过90%的嗜铬细胞瘤通过超声或计算机断层扫描检测到。间碘苄胍扫描似乎有帮助,不过存在一些假阴性病例。