ECE2016 Eposter Presentations Adrenal cortex (to include Cushing's) (85 abstracts)
Computerized tomography and magnetic resonance imaging features for differentiating functioning adrenal lesions from non-functioning adrenal lesions
Derya Koseoglu 1 , Mazhar Muslum Tuna 2 , Narin Nasiroglu Imga 1 , Bercem Aycicek Dogan 3 , Mehtap Navdar Basaran 4 , Cagdas Senel 5 , Altug Tuncel 5 , Dilek Berker 1 & Serdar Guler 1
1Ankara Numune Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey; 2Dicle University, Faculty of Medicine, Department of Endocrinology and Metabolism, Diyarbakir, Turkey; 3Kocaeli Darica State Hospital, Department of Endocrinology and Metabolism, Kocaeli, Turkey; 4Giresun State Hospital, Department of Endocrinology and Metabolism, Giresun, Turkey; 5Ankara Numune Education and Research Hospital, Department of Urology, Ankara, Turkey; 6Hitit University, Faculty of Medicine, Department of Endocrinology and Metabolism, Corum, Turkey.
Aim: The aim of the present study was to evaluate the characteristic features of computerized tomography (CT) and magnetic resonance imaging (MRI) among functioning and non-functioning adrenal lesions.
Materials and methods: We retrospectively reviewed the medical records of patients with adrenal mass. CT or MRI findings were available in 89 functioning and 148 non-functioning adrenal lesions (NFAL). Of the patients with functioning adrenal mass, 34 were diagnosed as Cushing’s syndrome, 32 as pheochromocytoma and 23 as primary hyperaldosteronism. Patients with functioning adrenal lesions were defined as group 1 and patients with NFAL were adopted as group 2.
Results: Patients in group 1 were younger, with a similar gender distribution. In patients with functioning adrenal mass, adenoma size, unenhanced and early arterial phase Hounsfield units (HU) were significantly higher compared to those with NFAL. Patients with pheochromocytoma had significantly larger lesions, higher unenhanced HU levels and lower washout values compared with NFAL, Cushing’s syndrome and primary hyperaldosteronism. Mean early arterial phase HU was higher in all functioning groups compared to NFAL. The best predictive cut-off value of early arterial phase HU for detecting functioning adrenal mass was 27 with a specificity of 80% and sensitivity of 82.7% on ROC curve analysis ((AUC:0.85, (95% CI 0.75–0.95)). On T1- weighted images 44.4% of the patients with functioning adrenal lesions were hypointense, whereas 18.9% of the patients with NFAL had hypointense lesions (P:0.02). T2-weighted images or chemical shift sequence in phase and out phase images between functioning and non-functioning adrenal adenomas showed no difference.
Conclusion: Our study revealed that functioning adrenal lesions might be discriminated from NFAL using CT characteristics, and T1- weighted MRI images. Especially early arterial phase HU, which is elevated in all functioning adrenal mass forms, can be used effectively to distinguish functioning adrenal lesions from NFAL.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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