Department of Radiology, University of California, Davis Medical Center, 4860 Y St, Ste 3100, Sacramento, CA 95817.
Department of Surgery, University of California, Davis Medical Center, Sacramento, CA.
AJR Am J Roentgenol. 2019 Sep;213(3):632-636. doi: 10.2214/AJR.19.21342. Epub 2019 Apr 30.
The purpose of this study is to determine the differences in growth rate of adrenal adenomas and malignant adrenal nodules. This was a retrospective review of adults with an adrenal nodule seen at two different abdominal or chest CT examinations or PET/CT examinations. Patients in the adenoma group were included if they had a CT, MRI, or pathologic diagnosis of an adrenal adenoma. Patients in the malignant group were included if they had a pathologically proven malignant adrenal nodule. Nodule growth was defined as a change in the largest axial diameter greater than or equal to 3 mm. Growth rate was calculated by dividing the change in the longest axial diameter by the time between the first and last imaging examination. There were 105 adenomas and 26 malignant nodules. Of the 105 adenomas, 34 (32.4%; 95% CI, 23.6-42.2%) grew, three (2.9%; 95% CI, 0.6-8.1%) became smaller, and 68 (64.8%; 95% CI, 54.8-73.8%), were unchanged in size. All 26 (100%; 95% CI, 89.1-100%) malignant nodules grew. The mean (± SD) growth rate of adenomas was 1.0 ± 0.67 mm/year (range, 0.3-2.8 mm/year), compared with 58.4 ± 78.5 mm/year (range, 5.8-395.4 mm/year) for malignant nodules ( < 0.001). A growth rate of 3 mm/year distinguished adenomas from malignant nodules with a sensitivity of 100% (95% CI, 86.8-100%) and a specificity of 100% (95% CI, 96.6-100%). Approximately one-third of radiologically proven adrenal adenomas grew, all of which grew at a rate less than 3 mm/year. All malignant adrenal nodules grew, and all at a rate greater than 5 mm/year.
本研究旨在确定肾上腺腺瘤和恶性肾上腺结节生长速度的差异。这是一项对在两次不同的腹部或胸部 CT 检查或 PET/CT 检查中发现肾上腺结节的成年人进行的回顾性研究。如果 CT、MRI 或病理诊断为肾上腺腺瘤，则将患者纳入腺瘤组。如果病理证实为恶性肾上腺结节，则将患者纳入恶性组。结节生长定义为最大轴向直径的变化大于或等于 3 毫米。生长速率通过将最长轴向直径的变化除以第一次和最后一次影像学检查之间的时间来计算。共发现 105 个腺瘤和 26 个恶性结节。在 105 个腺瘤中，有 34 个（32.4%；95%CI，23.6-42.2%）生长，3 个（2.9%；95%CI，0.6-8.1%）变小，68 个（64.8%；95%CI，54.8-73.8%）大小不变。所有 26 个（100%；95%CI，89.1-100%）恶性结节均生长。腺瘤的平均（±SD）生长速度为 1.0±0.67mm/年（范围，0.3-2.8mm/年），而恶性结节为 58.4±78.5mm/年（范围，5.8-395.4mm/年）（<0.001）。生长速度为 3mm/年可将腺瘤与恶性结节区分开来，其敏感性为 100%（95%CI，86.8-100%），特异性为 100%（95%CI，96.6-100%）。约三分之一的经影像学证实的肾上腺腺瘤生长，其生长速度均小于 3mm/年。所有恶性肾上腺结节均生长，且生长速度均大于 5mm/年。
