Computed tomography and magnetic resonance imaging features for differentiating functioning from non-functioning adrenal lesions

Authors

  • Derya Koseoglu Department of Endocrinology and Metabolism, Faculty of Medicine, Hitit University, Corum, Turkey
  • Mazhar Muslum Tuna Department of Endocrinology and Metabolism, Umraniye Education and Research Hospital, Istanbul, Turkey
  • Narin Nasiroglu Imga Department of Endocrinology and Metabolism, Saglik Bilimleri University, Ankara City Hospital, Ankara, Turkey
  • Bercem Aycicek Department of Endocrinology and Metabolism, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey
  • Mehtap Navdar Basaran Department of Endocrinology and Metabolism, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey
  • Cagdas Senel Department of Urology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
  • Altug Tuncel Department of Urology, Saglik Bilimleri University, Ankara City Hospital, Ankara, Turkey
  • Dilek Berker Department of Endocrinology and Metabolism, Saglik Bilimleri University, Ankara City Hospital, Ankara, Turkey
  • Serdar Guler Department of Endocrinology and Metabolism, Ankara Liv Hospital, Ankara, Turkey

Keywords:

Adrenal incidentaloma, computerized tomography, cushing’s syndrome, pheochromocytoma, primary hyperaldosteronism

Abstract

Aim: It is not well known whether the radiological features of adenomas differ between functioning and non-functioning adrenal lesions (NFAL). The aim of this study was to evaluate the characteristic features of computed tomography (CT) and magnetic resonance imaging (MRI) characteristics among functioning and non-functioning adrenal lesions.
Material and Methods: This retrospective study included 89 patients with functioning adrenal lesions and 148 patients with NFAL, whose CT or MRI findings were present. Group 1 included patients with functioning adrenal lesions and group 2 patients with NFAL.
Results: In patients with functioning adrenal mass, adenoma size (p:0.001), unenhanced and early-enhanced Hounsfield units (HU) (p<0.001) were significantly higher compared to those with NFAL. Among the patients with functioning adrenal mass; Cushing’s syndrome, pheochromocytoma and primary hyperaldosteronism were diagnosed in 34, 32 and 23 patients, respectively. Mean early-
enhanced HU was higher in all functioning groups compared to NFAL (p<0.001, all). ROC analysis showed 80% specificity and 82.7% sensitivity for determining functioning adrenal masses with an early-enhanced CT attenuation value of 27 HU. On T1-weighted images functioning adrenal lesions were more commonly hypointense than NFAL (p=0.02).
Conclusion: This study reveals that functioning adrenal lesions might be differentiating from NFAL using CT features. Especially early-enhanced CT attenuation, which is elevated in all functioning adrenal mass forms, may be used effectively for this purpose.

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Published

2021-12-23

How to Cite

Koseoglu, D., Tuna, M. M., Imga, N. N., Aycicek, B., Basaran, M. N., Senel, C., Tuncel, A., Berker, D., & Guler, S. (2021). Computed tomography and magnetic resonance imaging features for differentiating functioning from non-functioning adrenal lesions. Annals of Medical Research, 28(12), 2207–2212. Retrieved from https://annalsmedres.org/index.php/aomr/article/view/4002

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