Department of Radiology, Taizhou Hospital of Zhejiang Province, Shaoxing University, Taizhou, 312000, Zhejiang, China.
Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, 317000, Zhejiang, China.
Abdom Radiol (NY). 2022 Sep;47(9):3308-3317. doi: 10.1007/s00261-022-03593-3. Epub 2022 Jul 1.
Adrenal incidentalomas are common lesions found on abdominal imaging, most of which are lipid-rich adrenal adenomas. Imaging diagnoses differentiating lipid-poor adrenal adenomas (LPA) from non-adenomas (NA) are presently challenging to perform. The aim of the study was to investigate the diagnostic performance of the relative enhancement ratio parameter in identifying LPA from NA.
We retrospectively evaluated consecutively presenting patients with lipid-poor adrenal lesions (January 2015 to August 2021). Lesions were divided into LPA and NA (including hyperenhancing and hypoenhancing NA). Kruskal-Wallis and Bonferroni tests were used to determine the differences in feature parameters between these three groups. Receiver operating characteristic curve analysis was performed to determine the sensitivity for diagnosing LPA and NA at 95% specificity; the parameters were compared using the McNemar test.
A total of 253 patients (mean age, 55 ± 12 years; 135 men), 121 with LPA and 132 with NA, were analyzed herein. The sensitivity (achieved at 95% specificity) of the relative enhancement ratio was higher than that of unenhanced attenuation in differentiating LPA from NA (60% vs. 52%, p = 0.064). The relative enhancement ratio yielded a higher sensitivity than unenhanced attenuation (79% vs. 59%, p < 0.001) in differentiating LPA from hypoenhancing NA, and a lower sensitivity (26% vs. 69%, p < 0.001) in differentiating LPA from hyperenhancing NA.
The relative enhancement ratio showed better diagnostic performance than unenhanced attenuation in differentiating LPA from hypoenhancing NA, while simultaneously showing poor diagnostic performance in identifying LPA from all NA.
肾上腺偶发瘤是腹部影像学检查中常见的病变，其中大多数为富含脂质的肾上腺腺瘤。目前，影像学诊断难以区分脂性乏脂性腺瘤（LPA）与非腺瘤（NA）。本研究旨在探讨相对增强比参数在鉴别 LPA 与 NA 中的诊断性能。
我们回顾性评估了 2015 年 1 月至 2021 年 8 月连续就诊的脂性肾上腺病变患者。将病变分为 LPA 和 NA（包括高增强和低增强 NA）。使用 Kruskal-Wallis 和 Bonferroni 检验来确定三组间特征参数的差异。绘制受试者工作特征曲线来确定 95%特异性下诊断 LPA 和 NA 的敏感性；使用 McNemar 检验比较参数。
共分析了 253 例患者（平均年龄 55±12 岁；135 例男性），其中 121 例为 LPA，132 例为 NA。相对增强比在区分 LPA 和 NA 时的敏感性（达到 95%特异性）高于未增强衰减（60% vs. 52%，p=0.064）。相对增强比在区分 LPA 和低增强 NA 时的敏感性高于未增强衰减（79% vs. 59%，p<0.001），在区分 LPA 和高增强 NA 时的敏感性较低（26% vs. 69%，p<0.001）。
相对增强比在区分 LPA 和低增强 NA 时的诊断性能优于未增强衰减，而在鉴别 LPA 与所有 NA 时的诊断性能较差。
