化学位移 MRI 中“脂肪缺乏”肾上腺腺瘤的患病率。

Prevalence of 'Fat-Poor' Adrenal Adenomas at Chemical-Shift MRI.

机构信息

Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.

出版信息

Can Assoc Radiol J. 2024 Feb;75(1):98-106. doi: 10.1177/08465371231179881. Epub 2023 Jun 19.

DOI:10.1177/08465371231179881

PMID:37335612

Abstract

OBJECTIVE

: To determine the prevalence of 'fat-poor' adrenal adenomas at chemical-shift-MRI.

MATERIALS AND METHODS

: This prospective IRB approved study identified 104 consecutive patients with 127 indeterminate adrenal masses that underwent 1.5-T chemical-shift-MRI between 2021-2023. Two blinded radiologists independently measured: 1) 2-Dimensionsal (2D) chemical-shift signal intensity (SI)-index on 2D Chemical-shift-MRI (SI-index >16.5% diagnosed presence of microscopic fat), 2) unenhanced CT attenuation (in cases where unenhanced CT was available).

RESULTS

: From 127 adrenal masses, there were 94% (119/127) adenomas and 6% (8/127) other masses (2 pheochromocytoma, 5 metastases, 1 lymphoma). 98% (117/119) adenomas had SI-Index >16.5%, only 2% (2/119) adenomas were 'fat-poor' by MRI. SI-Index >16.5% was 100% specific for adenoma, all other masses had SI-Index <16.5%. Unenhanced CT was available in 43% (55/127) lesions (50 adenomas, 5 other masses). 34% (17/50) adenomas were lipid-poor (>10 HU). Percentage of adenomas with SI-Index >16.5% were: 1) ≤10 HU, 100% (33/33), 2) 11-29 HU, 100% (12/12), 3) ≥30 HU, 60% (3/5). No other masses had attenuation ≤10 HU (0/5).

CONCLUSION

: Fat-poor adrenal adenomas are uncommon using 2D chemical-shift signal intensity index >16.5% at 1.5-T, occurring in approximately 2% of adenomas in this large prospective series.

摘要

目的

在化学位移 MRI 中确定“脂肪缺乏”的肾上腺腺瘤的患病率。

材料和方法

本前瞻性 IRB 批准的研究纳入了 2021 年至 2023 年间在 1.5-T 进行化学位移 MRI 的 104 例连续的 127 例不确定肾上腺肿块患者。两名盲法放射科医生独立测量：1）二维（2D）化学位移信号强度（SI）-指数（2D 化学位移 MRI 上 SI-指数>16.5% 诊断为存在微观脂肪），2）未增强 CT 衰减（在有未增强 CT 的情况下）。

结果

从 127 个肾上腺肿块中，有 94%（119/127）为腺瘤，6%（8/127）为其他肿块（2 例嗜铬细胞瘤、5 例转移瘤、1 例淋巴瘤）。98%（117/119）的腺瘤 SI-Index>16.5%，只有 2%（2/119）的腺瘤 MRI 表现为“脂肪缺乏”。SI-Index>16.5%对腺瘤具有 100%的特异性，所有其他肿块的 SI-Index<16.5%。未增强 CT 可用于 43%（55/127）的病变（50 个腺瘤，5 个其他肿块）。34%（17/50）的腺瘤为脂质缺乏（>10 HU）。SI-Index>16.5%的腺瘤百分比为：1）≤10 HU，100%（33/33），2）11-29 HU，100%（12/12），3）≥30 HU，60%（3/5）。其他肿块的衰减均>10 HU（0/5）。