腎上腺腫塊mr的特征及診斷(完整版)
【正文】 h of the specimen shows a wellcircumscribed bright yellow nodule, an appearance that is typical of adrenocortical adenoma. 增強時均勻一致強化也是腎上腺腺瘤的特征，腎上腺腺瘤小的，圓點狀信號強度改變可能是由于囊變，出血或血供的差異。 it has a triangular, inverted Y, or V configuration. Normal adrenal glands range from 2 to 6 mm in thickness and from 2 to 4 cm in length. Figure 3. Coronal T1weighted, threedimensional, GRE MR image obtained with VIBE shows the normal inverted Y shape of the right adrenal gland (arrow 三 MRI檢查技術(shù)： 腎上腺成像最重要的是化學(xué)位移成像，可以通過擾相 GRE的 inphase and outofphase來完成。 腎上腺的血管分布：腎上腺上面有膈下動脈的終末分支，經(jīng)腎上腺靜脈出腎上腺。這些特征可用于大部分腎上腺占位：腺瘤，增生，單純或復(fù)雜囊腫，淋巴管瘤，髓樣脂肪瘤，嗜鉻細胞瘤 ,腎上腺出血，皮質(zhì)腺癌，神經(jīng)母細胞瘤，淋巴瘤和轉(zhuǎn)移瘤。 皮質(zhì)約占腎上腺體積的 80%～ 90%，根據(jù)皮質(zhì)細胞的形態(tài)結(jié)構(gòu)和排列等特征，可將皮質(zhì) 分為三個帶，即球狀帶、束狀帶和網(wǎng)狀帶。左側(cè)腎上腺位于左腎上極前中部 ，胰腺后方，呈三角形 ，倒 V或 Y形。 1，腎上腺腺瘤 腎上腺腺瘤是最常見腎上腺腫塊，尸檢發(fā)病率約 3% 。由成熟脂肪組織和造血組織構(gòu)成。 Figure 6. (a, b) Axial T1weighted MR images obtained without fat suppression and with fat suppression show typical MR imaging features of right adrenal myelolipoma. The fatty ponent of the myelolipoma (arrow in a) shows a decrease in signal intensity on the fatsuppressed image. Photomicrograph (original magnification, 100。 HE stain) shows a cystic lesion with a simple cuboidal mesothelial lining. 2，假性囊腫 假性囊腫是腎上腺囊性腫塊中第二多見。大部分嗜鉻細胞瘤增強時明顯強化。 MRI是腎上腺出血最敏感和最有效的檢查手段，根據(jù)不同的出血時期有不同的表現(xiàn)。 Figure 14. (a, b) Sagittal T1weighted threedimensional contrastenhanced GRE MR image obtained with VIBE and coronal T2weighted MR image obtained with halfFourier RARE show a large mass involving the right adrenal gland. The mass exhibits heterogeneous low signal intensity on the T1weighted image and high signal intensity with a heterogeneous pattern of contrast enhancement and areas of necrosis (arrow in b) on the T2weighted image. Photograph of the specimen shows a yellow and red tumor with large areas of necrosis, findingstypical of adrenocortical carcinoma. 2， 腎上腺淋巴瘤 淋巴瘤偶爾也可累及腎上腺，以非何杰金淋巴瘤多見，通常雙側(cè)受累， 占 50%。沒有在 outofphase上信號減低的特性（和腺瘤鑒別）。 神經(jīng)母細胞瘤 8090%有鈣化，但 MRI難以顯示。 Figure 18.
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