Tsushima Yoshito, Takahashi-Taketomi Ayako, Endo Keigo
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Hospital, Gunma, Japan.
J Magn Reson Imaging. 2009 Jan;29(1):112-7. doi: 10.1002/jmri.21616.
To determine the utility of diffusion-weighted MR imaging (DWI) for the diagnosis of adrenal tumors.
Forty-two patients (24 men and 18 women; age, 61.5 +/- 12.7 years old; range, 34-86 years) with 43 adrenal tumors (11 functioning cortical adenomas, 20 nonfunctioning cortical adenomas, 7 metastatic tumors, and 5 pheochromocytomas) were retrospectively investigated. DWIs were obtained by single-shot spin-echo type echo-planar imaging sequence (1.5 Tesla [T]; TR = 8000 ms, TE = 72, b-factor = 0 and 1000 s/mm(2)), and apparent diffusion coefficient (ADC) value was calculated. Chemical shift images were obtained by gradient echo sequence (TR = 161, TE = 2.38 [out-of-phase, OP] and 4.76 [in-phase, IP], FA = 60), and the signal intensity index (SII; [IP-OP]/IP *100%) was calculated.
There was no difference in ADC values between adenomas (1.09 +/- 0.2910(-3) mm(2)/s; range, 0.52-1.64) and metastatic tumors (0.85 +/- 0.2610(-3); 0.51-1.23; p = 0.14). Pheochromocytomas showed the higher mean ADC value (1.59 +/- 0.34*10(-3); 1.04-1.96) compared with those of adenomas or metastatic tumors (P < 0.05 and P < 0.005, respectively). The mean SII of adenomas (62.1 +/- 17.9%; 14.5-88.4) was significantly higher than those of pheochromocytomas (4.0 +/- 10.0%; -19.6-3.3; P < 0.005) or metastatic tumors (-1.5 +/- 11.7%; -18.3-8.2; P < 0.01). There was no correlation between ADC values and SII.
Although pheochromocytomas showed higher ADC values, we did not find that ADC value had diagnostic utility for differentiating adenomas and metastatic tumors.
确定扩散加权磁共振成像（DWI）在肾上腺肿瘤诊断中的效用。
回顾性研究42例患者（24例男性和18例女性；年龄61.5±12.7岁；范围34 - 86岁），共43个肾上腺肿瘤（11个功能性皮质腺瘤、20个无功能性皮质腺瘤、7个转移瘤和5个嗜铬细胞瘤）。通过单次激发自旋回波型回波平面成像序列（1.5特斯拉[T]；TR = 8000毫秒，TE = 72，b值 = 0和1000秒/毫米²）获得DWI图像，并计算表观扩散系数（ADC）值。通过梯度回波序列（TR = 161，TE = 2.38[反相位，OP]和4.76[同相位，IP]，翻转角 = 60）获得化学位移图像，并计算信号强度指数（SII；[IP - OP]/IP×100%）。
腺瘤（1.09±0.29×10⁻³毫米²/秒；范围0.52 - 1.64）和转移瘤（0.85±0.26×10⁻³；0.51 - 1.23；p = 0.14）的ADC值无差异。与腺瘤或转移瘤相比，嗜铬细胞瘤的平均ADC值更高（1.59±0.34×10⁻³；1.04 - 1.96）（分别为P < 0.05和P < 0.005）。腺瘤的平均SII（62.1±17.9%；14.5 - 88.4）显著高于嗜铬细胞瘤（4.0±10.0%； - 19.6 - 3.3；P < 0.005）或转移瘤（ - 1.5±11.7%； - 18.3 - 8.2；P < 0.01）。ADC值与SII之间无相关性。
虽然嗜铬细胞瘤显示出较高的ADC值，但我们未发现ADC值对区分腺瘤和转移瘤具有诊断效用。
