Villar Del Moral Jesús María, Muñoz Pérez Nuria, Rodríguez Fernández Antonio, Olmos Juárez Erika, Moreno Cortés Clotilde, Rodríguez González Rubén, Martín Cano Francisco Javier, Sánchez Sánchez Rocío, Ferrón Orihuela José Antonio
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de las Nieves, Granada, España.
Cir Esp. 2010 Oct;88(4):247-52. doi: 10.1016/j.ciresp.2010.07.007.
The usefulness of 18fluorodeoxyglucose positron emission tomography combined with axial tomography (PET-CT) in diagnosing whether adrenal tumours are benign or malignant is assessed.
A retrospective study conducted between June 2005 and May 2009 on a consecutive series of patients on whom a PET-CT scan was performed to study suspected malignant adrenal disease. Focal uptakes were assessed, along with the maximum standard uptake value (SUV), and the ratio of the maximum adrenal/hepatic value. The sensitivity, specificity, positive and negative predictive value of the test, the maximum adrenal uptake values and the ratio for those where the diagnostic yield was maximum.
Fifteen patients were included. The final diagnosis showed malignancy in eight and seven were benign. Ten patients had adrenal uptake: three in benign lesions and seven in neoplasias, with a mean uptake value of 6.3 (3.2 in benign lesions and 9.0 in malignant lesions). The mean adrenal/hepatic ratio was 1.8 (0.9 in benign and 2.6 in malignant lesions). When the presence of adrenal uptake is associated with a final diagnosis of malignancy, we obtained a sensitivity of 87.5%, a specificity of 57.1%, and a positive and negative predictive value of 70% and 80%, respectively. An SUV cut-off value of 6, or an adrenal/hepatic uptake ratio of 2, gave a sensitivity of 75%, a specificity of 100%, and a positive and negative predictive value of 100% and 77.7%, respectively.
PET-CT has a high ability to discriminate between benign and malignant lesions in the adrenal disease studied.
评估18氟脱氧葡萄糖正电子发射断层扫描联合轴向断层扫描（PET-CT）在诊断肾上腺肿瘤是良性还是恶性方面的效用。
对2005年6月至2009年5月期间连续进行PET-CT扫描以研究疑似恶性肾上腺疾病的一系列患者进行回顾性研究。评估了局灶性摄取情况，以及最大标准摄取值（SUV）和最大肾上腺/肝脏值的比率。该检查的敏感性、特异性、阳性和阴性预测值，以及诊断率最高的那些患者的最大肾上腺摄取值和比率。
纳入15例患者。最终诊断显示8例为恶性，7例为良性。10例患者有肾上腺摄取：良性病变中有3例，肿瘤中有7例，平均摄取值为6.3（良性病变为3.2，恶性病变为9.0）。平均肾上腺/肝脏比率为1.8（良性为0.9，恶性为2.6）。当肾上腺摄取与最终诊断为恶性相关时，我们获得的敏感性为87.5%，特异性为57.1%，阳性和阴性预测值分别为70%和80%。SUV临界值为6或肾上腺/肝脏摄取比率为2时，敏感性为75%，特异性为100%，阳性和阴性预测值分别为100%和77.7%。
PET-CT在研究的肾上腺疾病中对鉴别良性和恶性病变具有很高的能力。
