Malayeri Ashkan A, Zaheer Atif, Fishman Elliot K, Macura Katarzyna J
Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institution, Baltimore, MD 21287, USA.
J Comput Assist Tomogr. 2013 Jul-Aug;37(4):528-42. doi: 10.1097/RCT.0b013e31828b690d.
Adrenal masses are among the most common incidentally discovered lesions on cross-sectional imaging with estimated incidence of approximately 5%. In addition, adrenal lesions can also be detected as part of an endocrinology workup with suspicion of a functional adrenal mass. Regardless of the source of detection, it is crucial to differentiate a benign from a malignant process and furthermore utilize characteristic imaging appearance of different adrenal masses to facilitate diagnosis and guide management. There are numerous imaging protocols and postprocessing methods for evaluation of adrenal masses with high sensitivity and specificity with small differences between institutions. Currently, the most widely used imaging modality for evaluation of adrenal mass is computed tomography without and with contrast washout assessment. In this article, we review diagnostic approaches to adrenal masses using computed tomography and magnetic resonance imaging techniques and present imaging strategies utilized at our institution. The advantages and challenges of these imaging modalities for evaluation of adrenal pathologies are discussed.
肾上腺肿块是横断面成像中最常见的偶然发现的病变之一，估计发病率约为5%。此外，肾上腺病变也可作为怀疑功能性肾上腺肿块的内分泌检查的一部分被检测到。无论检测来源如何，区分良性和恶性病变并利用不同肾上腺肿块的特征性影像学表现来促进诊断和指导治疗都至关重要。有许多用于评估肾上腺肿块的成像方案和后处理方法，各机构之间差异不大，具有高敏感性和特异性。目前，评估肾上腺肿块最广泛使用的成像方式是平扫及增强CT并进行对比剂洗脱评估。在本文中，我们回顾了使用CT和MRI技术诊断肾上腺肿块的方法，并介绍了我们机构采用的成像策略。讨论了这些成像方式在评估肾上腺病变方面的优势和挑战。
