腎上腺腫塊mr的特征及診斷(參考版)
2025-05-29 18:14本頁(yè)面
【正文】 Figure 18. Axial inphase T1weighted MR image shows a heterogeneous mass with intermediate signal intensity involving the right adrenal gland. Photograph of the specimen shows a dark brown to tan lobulated ganglioneuroblastoma with areas of necrosis and pression of the adjacent kidney. There is a rim of residual yellow cortex 。 節(jié)細(xì)胞神經(jīng)母細(xì)胞瘤 T1WI上中等信號(hào)和 T2WI上不均勻高信號(hào)。 Figure 17. (a, b) Coronal unenhanced T1weighted MR image and axial T2weighted MR image obtained with inversion recovery show a right adrenal tumor. The tumor is predominantly hypointense on the T1weighted image and has areas of highsignalintensity hemorrhage (arrow in a). The tumor is hyperintense on the T2weighted image. ，節(jié)細(xì)胞神經(jīng)母細(xì)胞瘤 其潛在惡性度介于神經(jīng)母細(xì)胞瘤和節(jié)細(xì)胞神經(jīng)瘤之間。壞死區(qū)域能夠引起 T2WI高信號(hào)。 神經(jīng)母細(xì)胞瘤 8090%有鈣化，但 MRI難以顯示。 神經(jīng)母細(xì)胞瘤 T1WI上不均勻低信號(hào)和 T2WI上不均勻高信號(hào)。 起源于腎上腺髓質(zhì)的神經(jīng)脊或沿交感神經(jīng)連。 1，神經(jīng)母細(xì)胞瘤 神經(jīng)母細(xì)胞瘤是第二常見(jiàn)腹部腫瘤（在 Wilms tumor之后）。沒(méi)有在 outofphase上信號(hào)減低的特性（和腺瘤鑒別）。 MRI T1WI上低信號(hào)和 T2WI上高信號(hào)。 原發(fā)部位一般有：肺，腸道，乳腺，胰腺。增強(qiáng)后輕微強(qiáng)化。 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(jiàn)，通常雙側(cè)受累， 占 50%。 腎上腺皮質(zhì)腺癌可以有點(diǎn)狀細(xì)胞內(nèi)脂肪，在 outofphase上信號(hào)減低。 由于出血和壞死腎上腺皮質(zhì)腺癌在 T1WI和 T2WI上有不同表現(xiàn)，出血后演化產(chǎn)物，主要是正鐵血紅蛋白，能夠引起 T1WI高信號(hào)。高峰年齡為 3070歲，一般診斷時(shí)腫瘤比較大，約 620cm。 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(shí)期有不同的表現(xiàn)。兩側(cè)腎上腺皮質(zhì)增生占 Cushing綜合癥的45% ，結(jié)節(jié)性腎上腺皮質(zhì)增生僅占 3% 。腎上腺皮質(zhì)增生可以是彌漫性和結(jié)節(jié)性，常發(fā)生于兩側(cè)。 10%雙側(cè)， 10%腎上腺外， 10%發(fā)生于小孩，10%為惡性。大部分嗜鉻細(xì)胞瘤增強(qiáng)時(shí)明顯強(qiáng)化。 Figure 10. Coronal T1weighted, threedimensional, GRE MR image obtained with VIBE shows a lymphangi
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