Wernecke K, Galanski M
Radiologe. 1986 Apr;26(4):191-7.
The percutaneous approach to the adrenal glands is impeded by their high paraaortal subphrenic location. Regarding the information conveyed in literature and referring to our experience, a summary of the technique, indication and findings of percutaneous biopsy of the adrenal gland is presented. Percutaneous needle biopsy of the right adrenal gland is most easily performed by lateral transhepatic approach under sonographic guidance, while in biopsy of the left adrenal gland protection of the spleen, kidney, pancreas and stomach can only be achieved by dorsal approach under CT control. At present, the main indication for biopsy of the adrenal gland still is differentiation between metastases and non-functioning adenomas in tumor patients. Adequate technique provided, the sensitivity of punctures of the adrenal gland varies from 80 to 90%. Clinical suspicion of pheochromocytoma is an absolute contraindication for fine needle biopsy.
肾上腺位于膈下主动脉旁高位,经皮穿刺肾上腺会受到阻碍。结合文献报道及我们的经验,现对肾上腺经皮活检的技术、适应证及结果进行总结。在超声引导下,经肝外侧入路最容易进行右肾上腺的经皮穿刺活检,而左肾上腺活检时,在CT引导下经背部入路才能保护脾脏、肾脏、胰腺和胃。目前,肾上腺活检的主要适应证仍是肿瘤患者中转移瘤与无功能腺瘤的鉴别。若技术得当,肾上腺穿刺的敏感性在80%至90%之间。临床怀疑嗜铬细胞瘤是细针穿刺活检的绝对禁忌证。