The Clinical Application Of Multislice Spiral Ct Of Adrenal Tumors

PurposeTo study the application of MPR (multi -planer reconstruction) ,VR (volume rendering) and transparency on adrenal gland by spiral CT and discuss the direction of these technology for laparoscopic surgical operation . To study the application of differentiating adrenal adenomas and adrenal metastasis masses by three - period scan.Material and method10 health volunteers and 59 patients of adrenal gland lesions were retrospectively reviewed. CT scans were obtained with a HiSpeed Advantage scanner (Marconi Company, MX 8000) by using 120 kV and 199 mAs. , with bed - speed 3.5mm/sec ,0.825 pitchs . Thickness of each slice is 3.2 -5mm ,and interval of reconstruction is 1.5 -2.5mm. The window wide is 230 -360,and the window center is 40 -60 to observe. Each patient received a bolus of 80 -100 mL of iodinated contrast medium injected at a rate of 2.0 - 2. 5 ml/sec with a power injector. Artery period scan was perfronned at 23 - 27 s after the start of contrast material injection ,and vein period scan was at 60 - 80 s . A ROI -based segmentation CT value were measure on adrenal glands and adrenal masses . Three - dimensional models of the patients adrenal gland lesions were, generated based on CT image data by correlative software.ResultThere are 59 patients in this study,and 24 adrenal adenomas , 15 adrenal metastasis masses , and 20 other adrenal lesions,and 45 of them were confirmed by operation and pathology. 14 adrenal metastasis masses were diagnosized by CT and clinical symptom. And the value of adrenal cortex adenomas received from nonenhanced scan was 13.8Hu 9.5,and from enhanced scan in artery period, vein period were 53.6Hu 18.5,49. 7Hu 17.3Hu , respectively . The value of adrenal metastasis masses received from nonenhanced scan was 32. 1Hu 6.2,and from enhanced scan in artery period, vein period were 58. 2Hu 15. 3,63. 9Hu 17. 2 , respectively . The size of adrenal adenomas was 10 - 26mm(mean, 16. 6mm), heterogeneity, without cystic change and calcification, and the edge is smooth. Adrenal metastasis masses were heterogeneous, including necrosis area,without obvious calcification. The size of adrenal metastasis masses was 10 -75mm(mean,36mm). Reconstruction technology such as MPR ,VR and transparency could show the normal adrenal glands , adrenal gland lesions ,their outlines of structure and the relation to the organ nearby intuitionisticly. And the reconstruction images also can measure the size of the adrenal lesions, and they can set up the three - dimensional structure of the normal adrenal glands and adrenal glands lesions.ConclusionCT is the important means and tool to make a diagnose of the adrenal gland lesions. It has been shown that the value measurements at three -period CT can show the wash -out of adrenal lesions ,and get the differ-entiation between adrenal cortex adenomas and adrenal metastasis masses The three - dimensional reconstruction technology could show the adrenal gland and adrenal gland lesions s outline of structure and the relation to the organ nearby intuitionisticly. They can set up the three - dimensional structure of adrenal glands and adrenal glands lesions. According to these image,urologists could understand the three -dimensional structure of the adrenal masses before operation,and may perform operation easily by lap-aroscopy.