Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Int Urol Nephrol. 2012 Oct;44(5):1397-402. doi: 10.1007/s11255-012-0202-4. Epub 2012 Jul 14.
To establish the undisputed the value of washout rate for adrenal adenoma using delayed enhanced CT, we evaluated diagnostic performance of cut-off value and delayed time of washout rate by final pathologic diagnosis in a multicenter study.
We reviewed the pathologic and clinical records of 244 patients underwent adrenalectomies at 5 university hospitals between 2005 and 2009. We calculated the mean Housfield units (HU) of adrenal lesion at non-enhancing CT, and early and delayed enhanced CT using the region of interest. We used ROC curves to determine the specificity and sensitivity of non-enhanced CT scans and the washout rate according to the various cut-off for adrenal adenomas.
We divided the patients into adrenal adenoma group (n = 138) and non-adrenal adenoma group (n = 106) based on final pathologic report. Using the unenhanced images with a threshold of 10 HU, the sensitivity was 45.7 %, and the specificity was 97.1 %. Using the 15-min-washout rate with a threshold of 55 %, the sensitivity was 93.9 %, and the specificity was 95.8 %.
Regardless of various CT machines and protocols, a washout rate of 15-min-delayed CT was most useful in the diagnosis of adrenal adenomas due to the early inflow and outflow of contrast media in the tissues of adrenal adenomas.
通过延迟增强 CT 确定洗脱率在肾上腺腺瘤中的明确价值，我们通过最终病理诊断评估多中心研究中洗脱率的截断值和延迟时间的诊断性能。
我们回顾了 2005 年至 2009 年间在 5 所大学医院接受肾上腺切除术的 244 例患者的病理和临床记录。我们使用感兴趣区域计算非增强 CT、早期和延迟增强 CT 时肾上腺病变的平均 Housfield 单位 (HU)。我们使用 ROC 曲线根据不同的肾上腺腺瘤截断值确定非增强 CT 扫描和洗脱率的特异性和敏感性。
我们根据最终病理报告将患者分为肾上腺腺瘤组（n = 138）和非肾上腺腺瘤组（n = 106）。使用阈值为 10 HU 的未增强图像，敏感性为 45.7%，特异性为 97.1%。使用阈值为 55%的 15 分钟洗脱率，敏感性为 93.9%，特异性为 95.8%。
无论使用何种 CT 机和方案，由于肾上腺腺瘤组织中对比剂的早期流入和流出，15 分钟延迟 CT 的洗脱率最有助于诊断肾上腺腺瘤。
