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[肾上腺成像:解剖与病理(文献综述)]

[Adrenal imaging: anatomy and pathology (literature review)].

作者信息

Korb T A, Chernina V Yu, Blokhin I A, Aleshina O O, Vorontsov A V, Morozov S P, Gombolevskiy V A

机构信息

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department.

Endocrinology Research Centre.

出版信息

Probl Endokrinol (Mosk). 2021 Jun 7;67(3):26-36. doi: 10.14341/probl12752.

Abstract

This literature review focuses on the normal adrenal gland anatomy and typical imaging features necessary to evaluate benign and malignant lesions. In particular, adenoma, pheochromocytoma, metastases and adrenocortical carcinoma were discussed as some of the most common lesions. For this purpose, a review of relevant local and international literature sources up to January 2021 was conducted.In many cases, adrenal incidentalomas have distinctive features allowing characterization using noninvasive methods. It is possible to suspect a malignant nature and promptly refer the patient for the necessary invasive examinations in some cases. -Computed tomography, especially with intravenous contrast enhancement, is the primary imaging modality because it enables differential diagnosis. Magnetic resonance tomography remains a sensitive method in lesion detection and follow-up but is not very specific for determining the malignant potential. Positron emission computed tomography also remains an additional method and is used mainly for differential diagnosis of malignant tumors, detecting metastases and recurrences after surgical treatment. Ultrasound has a limited role but is nevertheless of great importance in the pediatric population, especially newborns. Promising techniques such as radiomics and dual-energy CT can expand imaging capabilities and improve diagnostic accuracy.Because adrenal lesions are often incidentally detected by imaging performed for other reasons, it is vital to interpret such findings correctly. This review should give the reader a broad overview of how different imaging modalities can evaluate adrenal pathology and guide radiologists and clinicians.

摘要

本综述聚焦于正常肾上腺的解剖结构以及评估良性和恶性病变所需的典型影像学特征。特别讨论了腺瘤、嗜铬细胞瘤、转移瘤和肾上腺皮质癌等一些最常见的病变。为此,对截至2021年1月的相关国内外文献进行了回顾。在许多情况下,肾上腺偶发瘤具有独特特征,可通过非侵入性方法进行特征描述。在某些情况下,有可能怀疑其恶性性质并及时将患者转诊进行必要的侵入性检查。计算机断层扫描,尤其是静脉注射造影剂增强扫描,是主要的影像学检查方法,因为它能够进行鉴别诊断。磁共振断层扫描在病变检测和随访中仍然是一种敏感的方法,但对于确定恶性潜能不太特异。正电子发射计算机断层扫描也是一种辅助方法,主要用于恶性肿瘤的鉴别诊断、检测转移瘤以及手术治疗后的复发情况。超声的作用有限,但在儿科人群,尤其是新生儿中仍然非常重要。放射组学和双能CT等有前景的技术可以扩展成像能力并提高诊断准确性。由于肾上腺病变常因其他原因进行的影像学检查而偶然发现,正确解读这些发现至关重要。本综述应使读者对不同的影像学检查方法如何评估肾上腺病变以及如何指导放射科医生和临床医生有一个全面的了解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f2/9753838/2ead5d0b4d98/problendo-67-12752-g001.jpg

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