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目的提高对肾上腺肿瘤的诊断水平。方法肾上腺肿瘤共44例,11例行18F-氟脱氧葡萄糖(18F-FDG)PET/CT、CT及MRI检查,余行CT和18F-FDGPET/CT检查,所有病例均行高血压试验和24h尿肾上腺素2项检测,术后病理或临床随访确诊。结果18F-FDGPET/CT对肿瘤良恶性诊断的敏感性、特异性分别为93.7%、100%,肿瘤诊断准确性为82.9%。CT分别为87.5%、96.4%和77.3%。MRI的肿瘤诊断准确性为81.8%。血浆醛固酮最高浓度在各肿瘤中差异无统计学意义(P>0.05)。髓质肿瘤与其他肾上腺肿瘤相比尿去甲基肾上腺素(NMN)、尿甲氧基肾上腺素(MN)、收缩压、舒张压差异均有统计学意义(P<0.05)。以3.1作为SUV临界值,得出PET/CT区分肿瘤良恶性敏感性和特异性最佳,分别为100%和96.2%。结论18F-FDGPET/CT在诊断肾上腺肿瘤良恶性上优于MRI和CT。高血压和尿NMN/MN成3倍以上升高对嗜铬细胞瘤的诊断意义重大。髓脂瘤、囊肿和嗜铬细胞瘤运用CT或MRI能较好诊断,非功能性和皮质肿瘤以PET/CT诊断为佳。
Objective To improve the diagnosis of adrenal tumors. Methods A total of 44 cases of adrenal tumors, 11 cases of 18F-fluorodeoxyglucose (18F-FDG) PET / CT, CT and MRI examination, CT and 18F-FDG PET / CT examination, all cases were subjected to high blood pressure test and 24h urine Adrenaline 2 test, postoperative pathology or clinical follow-up diagnosis. Results The sensitivity and specificity of 18F-FDG PET / CT for the diagnosis of benign and malignant tumors were 93.7% and 100% respectively, and the accuracy of tumor diagnosis was 82.9%. CT were 87.5%, 96.4% and 77.3% respectively. MRI diagnostic accuracy of the tumor was 81.8%. The highest plasma aldosterone concentration in each tumor was no significant difference (P> 0.05). Medullary neoplasms compared with other adrenal nephrine urine (NMN), urinary methoxine adrenaline (MN), systolic blood pressure, diastolic blood pressure were significantly different (P <0.05). Using 3.1 as the SUV threshold, it was concluded that PET / CT had the best sensitivity and specificity for benign and malignant tumors, which were 100% and 96.2% respectively. Conclusion 18F-FDG PET / CT is superior to MRI and CT in the diagnosis of benign and malignant adrenal tumors. Hypertension and urinary NMN / MN increased more than 3 fold for pheochromocytoma diagnosis of great significance. Myeloma, cyst and pheochromocytoma CT or MRI can be better diagnosed, non-functional and cortical tumors PET / CT diagnosis is better.