Fan Cun-Xia, Zhang Jia-Jun, Cai Ying-Ying, Wu Chun-Yan, Zou Shao-Zhou, Xu Yi-Kai, Xue Yao-Ming, Guan Mei-Ping
Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Aug 20;37(8):1054-1059. doi: 10.3969/j.issn.1673-4254.2017.08.09.
To investigate the prevalence, etiology and clinical characteristics of adrenal lesions detected by abdominal computed tomography (CT).
This retrospective study was conducted in patients with adrenal lesions detected by abdominal CT examinations in Nanfang Hospital between July, 2014 and June, 2015. The clinical data of the patients were collected for analysis of the demographics, comorbidities, imaging characteristics, biochemical profiles, clinical diagnosis and intervention.
A total of 939 patients with adrenal lesions were identified from 19 004 patients undergoing abdominal CT scan over the defined period. The mean age of the patients was 53.2 years and 560 of the patients were male. Among the total cases with adrenal lesions, the percentages of cases with adrenal masses tended to increase progressively with age. Endocrine studies were done in 270 of the total patients, which identified non-functioning masses in 38.9%, primary aldosteronism in 16.3%, Cushing's syndrome in 4.1%, subclinical Cushing's syndrome in 7.0%, and pheochromocytomas in 7.0% of the cases. Adrenal incidentalomas was detected in 191 patients, with a detection rate of 1.0% among the overall patients undergoing abdominal CT scans. Imaging study detected adenomas (70.3%), cortical carcinomas (2.4%), and metastases (0.5%). Of 191 patients with adrenal incidentalomas, only 76 (39.8%) underwent endocrine evaluation, including 34 with nonfunctioning adrenal masses, 17 with pheochromocytoma, 7 with primary aldosteronism, and 5 with subclinical Cushing's syndrome.
s The overall detection rates of adrenal lesions and adrenal incidentalomas by abdominal CT were 4.9% and 1.0%, respectively, in our cohort of patients undergoing the examination over the defined period. Although most of the lesions were benign and nonfunctioning, malignant and functional lesions were also detected. As many as 60% of the patients with adrenal incidentalomas did not have hormonal testing. Clinicians need to have greater awareness of adrenal incidentalomas and standard protocol for its management should be established.
探讨腹部计算机断层扫描（CT）检测出的肾上腺病变的患病率、病因及临床特征。
本回顾性研究纳入了2014年7月至2015年6月在南方医院接受腹部CT检查发现肾上腺病变的患者。收集患者的临床资料，分析人口统计学、合并症、影像特征、生化指标、临床诊断及干预情况。
在规定时间内接受腹部CT扫描的19004例患者中，共识别出939例肾上腺病变患者。患者的平均年龄为53.2岁，其中560例为男性。在所有肾上腺病变病例中，肾上腺肿块病例的百分比随年龄增长呈逐渐上升趋势。对270例患者进行了内分泌检查，结果显示无功能肿块占38.9%，原发性醛固酮增多症占16.3%，库欣综合征占4.1%，亚临床库欣综合征占7.0%，嗜铬细胞瘤占7.0%。191例患者检测出肾上腺偶发瘤，在接受腹部CT扫描的所有患者中的检出率为1.0%。影像检查发现腺瘤占70.3%，皮质癌占2.4%，转移瘤占0.5%。191例肾上腺偶发瘤患者中，仅76例（39.8%）接受了内分泌评估，其中无功能肾上腺肿块34例，嗜铬细胞瘤17例，原发性醛固酮增多症7例，亚临床库欣综合征5例。
在我们规定时间内接受检查的患者队列中，腹部CT对肾上腺病变和肾上腺偶发瘤的总体检出率分别为4.9%和1.0%。虽然大多数病变为良性且无功能，但也检测到了恶性及功能性病变。多达60%的肾上腺偶发瘤患者未进行激素检测。临床医生需要提高对肾上腺偶发瘤的认识，并应建立其管理的标准方案。
