PDF(Pubmed)
Abstract：
Background and Objectives: Primary adrenal tumors (AT) are a heterogeneous group of neoplasms due to their functional heterogeneity, which results in the diverse clinical presentation of these tumors. The purpose of this study was to examine cross-sectional imaging characteristics using multi-detector computed tomography (MDCT) to provide insight into the lesion characterization and functional status of these tumors. The radionuclide imaging using Technetium-99m radiolabeled hydrazinonicotinylacid-d-phenylalanyl1-tyrosine3-octreotide (99mTc-HYNIC-TOC), was also used in the diagnostic evaluation of these tumors. Materials and Methods: This cross-sectional study included 50 patients with confirmed diagnoses of AT (21 hormone-secreting and 29 non-functional) at the University Clinical Center, Kragujevac, Serbia, during the 2019-2022 year period. The morphological and dynamic characteristics using MDCT were performed, using qualitative, semi-quantitative, and quantitative analysis. Absolute washout (APW) and relative washout (RPW) values were also calculated. A semi-quantitative analysis of all visual findings with 99mTc-HYNIC-TOC was performed to compare the tumor to non-tumor tracer uptake. Results: A statistically significant difference was found in the MDCT values in the native phase (p < 0.05), the venous phase (p < 0.05), and the delayed phase (p < 0.001) to detect the existence of adrenal tumors. Most of these functional adrenocortical lesions (n = 44) can be differentiated using the delayed phase (p < 0.05), absolute percentage washout (APW) (p < 0.05), and relative percentage washout (RPW) (p < 0.001). Furthermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumor existence (p < 0.001). There is a positive correlation between radionuclide imaging scan and APW to detect all AT (p < 0.01) and adrenocortical adenomas as well (p < 0.01). Conclusions: The results can be very helpful in a diagnostic algorithm to quickly and precisely diagnose the expansive processes of the adrenal glands, as well as to learn about the advantages and limitations of the mentioned imaging modalities.
摘要：
背景与目的:原发性肾上腺肿瘤(AT)由于其功能异质性,是一类异质性肿瘤,这导致这些肿瘤的不同临床表现。这项研究的目的是使用多探测器计算机断层扫描（MDCT）检查横截面成像特征，以深入了解这些肿瘤的病变特征和功能状态。使用99m放射性标记的肼基烟酸-d-苯丙氨酰1-酪氨酸3-奥曲肽（99mTc-HYNIC-TOC）进行放射性核素成像，也用于这些肿瘤的诊断评估。材料和方法：这项横断面研究包括在大学临床中心确认诊断为AT的50例患者（21个激素分泌和29个非功能性），克拉古耶瓦茨,塞尔维亚,在2019-2022年期间。使用MDCT进行了形态和动态特征，使用定性的，半定量，和定量分析。还计算了绝对洗脱(APW)和相对洗脱(RPW)值。使用99mTc-HYNIC-TOC对所有视觉发现进行半定量分析，以比较肿瘤与非肿瘤示踪剂的摄取。结果：在自然相中发现MDCT值具有统计学意义（p<0.05），静脉期（p<0.05），和延迟期(p<0.001)检测肾上腺肿瘤的存在。大多数这些功能性肾上腺皮质病变（n=44）可以使用延迟期（p<0.05）进行区分，绝对冲洗百分比(APW)(p<0.05)，和相对冲洗百分比(RPW)(p<0.001)。此外，99mTc-HYNIC-TOC对肾上腺肿瘤的存在具有较高的诊断率(p<0.001)。放射性核素显像扫描与APW检测所有AT（p<0.01）和肾上腺皮质腺瘤（p<0.01）之间呈正相关。结论：该结果对于快速，准确地诊断肾上腺的扩张过程的诊断算法非常有帮助。以及了解上述成像模式的优点和局限性。
