Original Article
Differential diagnosis of adrenal metastasis and lipid-poor adrenal adenoma with CT
Changtong Shan, Jian Wang, Hongjie Hu
Published 2018-06-25
Cite as Chin J Endocr Surg, 2018, 12(3): 251-257. DOI: 10.3760/cma.j.issn.1674-6090.2018.03.018
Abstract
ObjectiveTo study the CT characteristics of adrenal metastasis (AM) and lipid-poor adrenal adenoma (Lp-AA) .
MethodsWe retrospectively analyzed clinical and CT dates of AM (n=25) and Lp-AA (n=61) which were pathologically or clinically confirmed. The size, location, number, contour, cystic degeneration, cal-cification, hemorrhage and the clinical data were analyzed, as well as, CT value of tumor were measured and calcu-lated. Receiver operating characteristic (ROC) curves were employed to assess the significant continuous variables to tell AM from Lp-AA.
Results34 adrenal lesions were detected for 25 cases of AM (9 case showed bilateral with 18 lesions) . There were 65 lesions for 61 cases of Lp-AA (3 cases showed bilateral and 1case showed two lesions in unilateral side) . Sex and age had significant difference between the two groups (P<0.05) . On the categorical vari-ables of CT examination, number, cystic degeneration and contour had significant difference between the two groups (P<0.05) , while tumor location, hemorrhage and calcification had no significant difference (P>0.05) . For the con-tinuous variables, plain scan CT value, enhancement amplitude, relative percentage washout (RPW) and tumor size had significant difference between the two groups (P<0.05) . Area under ROC curve analysis showed that when the plain scan CT value>30.4 HU, area under ROC curve, sensitivity and specificity were 0.878, 91.2%, and 72.3%, re-spectively. When RPW was >-33.4%, the area under ROC curve, sensitivity and specificity were 0.643, 79.4%,64.7%, respectively. When the maximum and minimum diameter of tumor were >2.9 cm and 2.2 cm respectively, the area under the curve, sensitivity, specificity were 0.762, 73.5%, 75.4% and 0.706, 64.7%, 69.2%, respectively. When venous phase increase and the largest increase were <37.7 HU and 37.3 HU respectively, the area under the curve, sensitivity, specificity were 0.805, 89.2%, 64.7% and 0.833, 95.4%, 64.7% respectively.
ConclusionTu-mor size, number, contour, cystic degeneration, CT measured and calculated value, as well as the patients’clinical data are of great value in differentiating AM and Lp-AA.
Key words:
Adrenal tumor; Metastasis; Lipid-poor adenoma; Differential diagnosis; Tomography; X-ray computed
Contributor Information
Changtong Shan
Department of Medical Imaging, Jinhua Wenrong Hospital, Jinhua 321017, China
Jian Wang
Department of Radi-ology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
Hongjie Hu
Department of Radiology, Sir Run Run Shaw Hospital, Hangzhou 310020, China
