Jalil N D, Pattou F N, Combemale F, Chapuis Y, Henry J F, Peix J L, Proye C A
Clinique Chirurgicale, Hopital Huriez, Lille, France.
Eur J Surg. 1998 Jan;164(1):23-8. doi: 10.1080/110241598750004913.
To find out the optimal strategy for the preoperative location of pheochromocytomas and paragangliomas.
Retrospective study.
282 patients operated on for histologically confirmed pheochromocytoma in France between 1980 and 1991, the past decade.
The results of imaging procedures, i.e. computed tomography (CT), (131)I meta-iodobenzylguanidine scintigraphy (MIBG) and magnetic resonance imaging (MRI) were reviewed.
Pheochromocytomas were sporadic in 206 (73%). They were unilateral in 189 (67%), bilateral in 54 (19%) and extra-adrenal in 39 (14%). Overall sensitivity of the studies was 89% for CT, 98% for MRI, and 81% for (131)I-MIBG. In unilateral adrenal lesions sensitivity were 100% for CT and MRI, and 88% for (131)I-MIBG; in bilateral lesions 66% for CT, 100% for MRI, and 62% for (131)I-MIBG; in extra-adrenal lesions 64% for CT, 88% for MRI, and 64% for (131)I-MIBG.
The accuracy with which pheochromocytomas and paragangliomas can be visualized questions nowadays the routine use of abdominal approach. In selected cases of sporadic unilateral chromaffin tumours, a posterior, lateral, or even laparoscopic approach should be considered.
探寻嗜铬细胞瘤和副神经节瘤术前定位的最佳策略。
回顾性研究。
1980年至1991年（过去十年）间在法国接受手术且经组织学确诊为嗜铬细胞瘤的282例患者。
回顾成像检查结果，即计算机断层扫描（CT）、碘-131间碘苄胍闪烁显像（MIBG）和磁共振成像（MRI）。
206例（73%）嗜铬细胞瘤为散发性。其中189例（67%）为单侧，54例（19%）为双侧，39例（14%）为肾上腺外。各项检查的总体敏感性分别为：CT为89%，MRI为98%，碘-131-MIBG为81%。对于单侧肾上腺病变，CT和MRI的敏感性为100%，碘-131-MIBG为88%；对于双侧病变，CT为66%，MRI为100%，碘-131-MIBG为62%；对于肾上腺外病变，CT为64%，MRI为88%，碘-131-MIBG为64%。
如今嗜铬细胞瘤和副神经节瘤的可视化准确性对腹部手术常规入路的使用提出了质疑。在散发性单侧嗜铬细胞瘤的特定病例中，应考虑采用后入路、侧入路甚至腹腔镜入路。
