Faculty of Medicine, Department of Radiology, Eskişehir Osmangazi University, Eskişehir, Turkey.
Exp Clin Endocrinol Diabetes. 2022 Jun;130(6):368-373. doi: 10.1055/a-1547-9008. Epub 2021 Aug 6.
The majority of Cushing's syndrome (CS) cases constitute patients with functional adrenal adenomas. In adrenal CS, visceral adipose tissue (VAT) area, VAT/subcutaneous adipose tissue (SAT), and VAT/total adipose tissue (TAT) ratios are expected to decrease in response to adrenalectomy, although no change is expected in non-functioning adrenal adenomas (NFA).
To evaluate the changes in VAT, SAT, TAT areas and VAT/SAT, VAT/TAT ratios using computed tomography (CT) in patients who underwent adrenalectomy due to adenomas.
Preoperative and postoperative CT of 32 patients (16 with CS and 16 with NFA) were retrospectively evaluated. The VAT, SAT, TAT areas were obtained from CT at the level of L1-2 intervertebral disc space, and the VAT/SAT, VAT/TAT ratios were calculated. The postoperative parameter changes in both groups were evaluated compared to the preoperative values. The level of statistical significance was considered as p<0.05.
The time interval between preoperative and postoperative CT measurements were 10.37 months (6-17) in CS and 9.75 months (7-15) in NFA groups (p=073). Preoperative CT indicated that the patients with CS had larger VAT and TAT areas (p=0.03, p=0.02) but SAT remained unchanged (p=0.08). However, postoperative CT revealed that there was no difference between the two groups in terms of VAT, TAT, and SAT areas (p=0.87, p=0.36, p=0.14). Postoperatively, in patients with CS, there was a decrease in VAT and TAT areas (p=0.01 for both) and VAT/SAT and VAT/TAT ratios (p=0.03, p=0.02) but SAT remained unchanged (p=0.10). In patients with NFA, no change was detected in the postoperative SAT, TAT, and VAT areas (p=0.12, p=0.40, p=0.99) or the VAT/SAT and VAT/TAT ratios (p=0.38, p=0.62).
Adrenalectomy is an effective treatment method leading to a decrease in the VAT, TAT areas, and VAT/SAT and VAT/TAT ratios in patients with cortisol producing adrenocortical adenoma. Thus, CT facilitates quantitative demonstration of the changes while evaluating the response of these patients to treatment.
大多数库欣综合征（CS）病例为功能性肾上腺腺瘤患者。在肾上腺 CS 中，预计内脏脂肪组织（VAT）面积、VAT/皮下脂肪组织（SAT）和 VAT/总脂肪组织（TAT）比值会在肾上腺切除术治疗后下降，尽管无功能肾上腺腺瘤（NFA）不会发生变化。
评估因腺瘤而接受肾上腺切除术的患者的 CT 检查中 VAT、SAT、TAT 面积和 VAT/SAT、VAT/TAT 比值的变化。
回顾性评估了 32 例患者（16 例 CS 和 16 例 NFA）的术前和术后 CT。通过 L1-2 椎间盘水平的 CT 获得 VAT、SAT、TAT 面积，并计算 VAT/SAT、VAT/TAT 比值。比较两组患者的术后参数与术前值的变化。统计学意义水平被认为是 p<0.05。
CS 组术前与术后 CT 测量的时间间隔为 10.37 个月（6-17），NFA 组为 9.75 个月（7-15）（p=0.73）。术前 CT 表明 CS 患者的 VAT 和 TAT 面积更大（p=0.03，p=0.02），但 SAT 保持不变（p=0.08）。然而，术后 CT 显示两组在 VAT、TAT 和 SAT 面积方面没有差异（p=0.87，p=0.36，p=0.14）。术后 CS 患者的 VAT 和 TAT 面积下降（p=0.01），VAT/SAT 和 VAT/TAT 比值下降（p=0.03，p=0.02），但 SAT 保持不变（p=0.10）。NFA 患者术后 SAT、TAT 和 VAT 面积以及 VAT/SAT 和 VAT/TAT 比值均无变化（p=0.12，p=0.40，p=0.99；p=0.38，p=0.62）。
肾上腺切除术是一种有效的治疗方法，可导致皮质醇产生的肾上腺皮质腺瘤患者的 VAT、TAT 面积以及 VAT/SAT 和 VAT/TAT 比值下降。因此，CT 有助于定量显示这些患者对治疗的反应。
