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Abdominal Radiology

Erschienen in:

01.07.2022 | Kidneys, Ureters, Bladder, Retroperitoneum

Diagnostic value of the relative enhancement ratio of the portal venous phase to unenhanced CT in the identification of lipid-poor adrenal tumors

verfasst von: Shengze Jin, Huangqi Zhang, Wenting Pan, Jiawen Yang, Binhao Zhang, Xue Dong, Xin Li, Xiuli Wu, Wenbin Ji

Erschienen in: Abdominal Radiology | Ausgabe 9/2022

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

Graphical abstract

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Titel: Diagnostic value of the relative enhancement ratio of the portal venous phase to unenhanced CT in the identification of lipid-poor adrenal tumors
verfasst von: Shengze Jin
Huangqi Zhang
Wenting Pan
Jiawen Yang
Binhao Zhang
Xue Dong
Xin Li
Xiuli Wu
Wenbin Ji
Publikationsdatum: 01.07.2022
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 9/2022
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-022-03593-3

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Diagnostic value of the relative enhancement ratio of the portal venous phase to unenhanced CT in the identification of lipid-poor adrenal tumors