Li Guo, Qin Xin, Cai Qinlei, Liao Yuting, Luo Shishi, Guo Shanxi, Chen Feng, Huang Weiyuan
Department of Radiology, Hainan Hospital of Hainan Medical University/Hainan General Hospital, Haikou, China.
Philips Healthcare, GuangZhou, China.
Abdom Radiol (NY). 2025 Jun 4. doi: 10.1007/s00261-025-05025-4.
In nodule-negative primary aldosteronism (PA), quantitative CT findings in unilateral PA differed from those in bilateral PA. We attempted to identify PA by quantitative parameters of contrast-enhanced CT.
A retrospective search was performed for 81 patients with nodule-negative PA who underwent contrast-enhanced CT between January 2021 and November 2024 and adrenal vein sampling thereafter at XXXX. The test cohort and validation cohort were enrolled separately based on the PA type. The optimal cutoff value for identifying PA was analyzed and calculated in the test cohort, and its diagnostic performance was subsequently evaluated in the validation cohort.
In the venous phase of the test cohort, the SD difference or ratio was significantly higher in unilateral-left PA than in bilateral PA [SD difference: 6.3 (4.4, 8.8) Hu vs. 2.5 (1.5, 4.4) Hu, P < 0.001; SD ratio: 1.2 (1.1, 1.3) vs. 1.1 (1.0, 1.1), P < 0.001]. At a cutoff value of 4.90 Hu, the sensitivity and specificity of the SD difference in predicting PA type were 0.733 and 0.957, respectively. The sensitivity and specificity of the SD ratio were 0.867 and 0.723 at a cutoff value of 1.130, respectively. In the validation cohort, the diagnostic performance of the SD difference in identifying PA type was similar to that of the SD ratio (0.801 vs. 0.917, P = 0.06).
Patients with nodule-negative PA can be further differentiated by bilateral adrenal heterogeneity on contrast-enhanced CT. The SD difference has similar predictive ability as the SD ratio.
在无结节性原发性醛固酮增多症（PA）中，单侧PA的CT定量表现与双侧PA不同。我们试图通过增强CT的定量参数来识别PA。
对2021年1月至2024年11月期间接受增强CT检查且之后在XXXX进行肾上腺静脉采样的81例无结节性PA患者进行回顾性研究。根据PA类型分别纳入测试队列和验证队列。在测试队列中分析并计算识别PA的最佳截断值，随后在验证队列中评估其诊断性能。
在测试队列的静脉期，单侧左PA的标准差差异或比值显著高于双侧PA [标准差差异：6.3（4.4，8.8）Hu对2.5（1.5，4.4）Hu，P < 0.001；标准差比值：1.2（1.1，1.3）对1.1（1.0，1.1），P < 0.001]。在截断值为4.90 Hu时，标准差差异预测PA类型的敏感性和特异性分别为0.733和0.957。在截断值为1.130时，标准差比值的敏感性和特异性分别为0.867和0.723。在验证队列中，标准差差异识别PA类型的诊断性能与标准差比值相似（0.801对0.917，P = 0.06）。
无结节性PA患者可通过增强CT上双侧肾上腺异质性进一步区分。标准差差异与标准差比值具有相似的预测能力。
