Nunes Thiago F, Szejnfeld Denis, Szejnfeld Jacob, Kater Claudio E, Faintuch Salomão, Castro Charlles H M, Goldman Suzan M
1 Department of Diagnostic Imaging, Federal University of São Paulo, Rua Napoleão de Barros, 800, Vila Clementino, 04024-000, São Paulo, Brazil.
2 Steroid Laboratory, Discipline of Endocrinology, Federal University of São Paulo, São Paulo, Brazil.
AJR Am J Roentgenol. 2016 Oct;207(4):804-810. doi: 10.2214/AJR.16.16207. Epub 2016 Aug 4.
The objective of this study was to establish the suitability of the apparent diffusion coefficient (ADC) as a parameter for evaluating early treatment response after percutaneous ablation of functional adrenal adenomas.
Seventeen adult patients with functioning adrenal adenomas underwent radiofrequency ablation. Serum hormone levels were analyzed before and up to 6 months after ablation. MRI findings (nodule size in cm, signal intensity index, ADC maps, and nodule-to-muscle ADC ratio) were analyzed before and up to 30 days after ablation. A consensus review of all scans was performed by two attending abdominal imaging radiologists. The procedure was considered successful if serum hormone levels normalized and no contrast enhancement of the adrenal lesion was seen on follow-up MRI.
Of 17 patients who underwent radiofrequency ablation, complete response was achieved in 16 patients with partial response in one patient. Of the four parameters of interest, only ADC maps and nodule-to-muscle ADC ratio showed statistically significant differences (p < 0.05).
This prospective study suggests that apparent diffusion coefficient values may help radiologists monitor early treatment response after CT-guided radiofrequency ablation of functioning adrenal adenomas.
本研究的目的是确定表观扩散系数(ADC)作为评估功能性肾上腺腺瘤经皮消融术后早期治疗反应参数的适用性。
17例患有功能性肾上腺腺瘤的成年患者接受了射频消融治疗。在消融术前及术后长达6个月的时间里分析血清激素水平。在消融术前及术后长达30天的时间里分析MRI表现(结节大小,以厘米为单位、信号强度指数、ADC图以及结节与肌肉的ADC比值)。由两名腹部影像诊断主治医师对所有扫描结果进行会诊。如果血清激素水平恢复正常且在随访MRI上未发现肾上腺病变有强化,则认为该手术成功。
在接受射频消融治疗的17例患者中,16例获得完全缓解,1例部分缓解。在四个感兴趣的参数中,只有ADC图和结节与肌肉的ADC比值显示出统计学上的显著差异(p<0.05)。
这项前瞻性研究表明,表观扩散系数值可能有助于放射科医生监测CT引导下功能性肾上腺腺瘤射频消融术后的早期治疗反应。