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30.10.2015 | Urogenital

MDCT Linear and Volumetric Analysis of Adrenal Glands: Normative Data and Multiparametric Assessment

verfasst von: Aline Carsin-Vu, Nadia Oubaya, Sébastien Mulé, Annaëlle Janvier, Brigitte Delemer, Philippe Soyer, Christine Hoeffel

Erschienen in: European Radiology | Ausgabe 8/2016

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Abstract

Objectives

To study linear and volumetric adrenal measurements, their reproducibility, and correlations between total adrenal volume (TAV) and adrenal micronodularity, age, gender, body mass index (BMI), visceral (VAAT) and subcutaneous adipose tissue volume (SAAT), presence of diabetes, chronic alcoholic abuse and chronic inflammatory disease (CID).

Methods

We included 154 patients (M/F, 65/89; mean age, 57 years) undergoing abdominal multidetector row computed tomography (MDCT). Two radiologists prospectively independently performed adrenal linear and volumetric measurements with semi-automatic software. Inter-observer reliability was studied using inter-observer correlation coefficient (ICC). Relationships between TAV and associated factors were studied using bivariate and multivariable analysis.

Results

Mean TAV was 8.4 ± 2.7 cm³ (3.3–18.7 cm³). ICC was excellent for TAV (0.97; 95 % CI: 0.96–0.98) and moderate to good for linear measurements. TAV was significantly greater in men (p < 0.0001), alcoholics (p = 0.04), diabetics (p = 0.0003) and those with micronodular glands (p = 0.001). TAV was lower in CID patients (p = 0.0001). TAV correlated positively with VAAT (r = 0.53, p < 0.0001), BMI (r = 0.42, p < 0.0001), SAAT (r = 0.29, p = 0.0003) and age (r = 0.23, p = 0.005). Multivariable analysis revealed gender, micronodularity, diabetes, age and BMI as independent factors influencing TAV.

Conclusions

Adrenal gland MDCT-based volumetric measurements are more reproducible than linear measurements. Gender, micronodularity, age, BMI and diabetes independently influence TAV.

Key Points

• Volumetric measurements are more reproducible than linear measurements for adrenal glands.

• Inter-observer reproducibility of adrenal gland volume is excellent using semiautomatic software.

• Gender, age, BMI, and diabetes independently influence total adrenal gland volume.

• Adrenal micronodularity is associated with increased total adrenal gland volume.

Johnson PT, Horton KM, Fishman EK (2009) Adrenal imaging with multidetector CT: evidence-based protocol optimization and interpretative practice. Radiographics 29:1319–1331CrossRefPubMed

Schek J, Macht S, Klasen-Sansone J et al (2013) Clinical impact of hyperattenuation of adrenal glands on contrast-enhanced computed tomography of polytraumatised patients. Eur Radiol 24:527–530CrossRefPubMed

Helck A, Hummel N, Meinel FG, Johnson T, Nikolaou K, Graser A (2014) Can single-phase dual-energy CT reliably identify adrenal adenomas? Eur Radiol 24:1636–1642CrossRefPubMed

Sohaib SA, Hanson JA, Newell-Price JD et al (1999) CT appearance of the adrenal glands in adrenocorticotrophic hormone-dependent Cushing’s syndrome. Am J Roentgenol 172:997–1002CrossRef

Lingam RK, Sohaib SA, Vlahos I et al (2003) CT of primary hyperaldosteronism (Conn’s syndrome): the value of measuring the adrenal gland. Am J Roentgenol 181:843–849CrossRef

Gülmez I, Keleştimur F, Durak AC, Ozesmi M (1996) Changes in the size of adrenal glands in acute pulmonary tuberculosis with therapy. Endocr J 43:573–576CrossRefPubMed

Yildiz O, Gokce C, Alp E et al (2005) Investigation of the hypothalamo-pituitary-adrenal axis and changes in the size of adrenal glands in acute brucellosis. Endocr J 52:183–188CrossRefPubMed

Golden SH, Wand GS, Malhotra S, Kamel I, Horton K (2011) Reliability of hypothalamic–pituitary–adrenal axis assessment methods for use in population-based studies. Eur J Epidemiol 26:511–525CrossRefPubMedPubMedCentral

Amsterdam JD, Marinelli DL, Arger P, Winokur A (1987) Assessment of adrenal gland volume by computed tomography in depressed patients and healthy volunteers: a pilot study. Psychiatry Res 21:189–197CrossRefPubMed

10.

Kessing LV, Willer IS, Knorr U (2011) Volume of the adrenal and pituitary glands in depression. Psychoneuroendocrinology 36:19–27CrossRefPubMed

11.

Ludescher B, Najib A, Baar S et al (2008) Increase of visceral fat and adrenal gland volume in women with depression: preliminary results of a morphometric MRI study. Int J Psychiatry Med 38:229–240CrossRefPubMed

12.

Ludescher B, Leitlein G, Schaefer J-E et al (2009) Changes of body composition in bulimia nervosa: increased visceral fat and adrenal gland size. Psychosom Med 71:93–97CrossRefPubMed

13.

Jenkins PJ, Sohaib SA, Trainer PJ, Lister TA, Besser GM, Reznek R (1999) Adrenal enlargement and failure of suppression of circulating cortisol by dexamethasone in patients with malignancy. Br J Cancer 80:1815–1819CrossRefPubMedPubMedCentral

14.

Benitah N, Yeh BM, Qayyum A, Williams G, Breiman RS, Coakley FV (2005) Minor morphologic abnormalities of adrenal glands at CT: prognostic importance in patients with lung cancer. Radiology 235:517–522CrossRefPubMed

15.

Nougaret S, Jung B, Aufort S, Chanques G, Jaber S, Gallix B (2010) Adrenal gland volume measurement in septic shock and control patients: a pilot study. Eur Radiol 20:2348–2357CrossRefPubMed

16.

Jung B, Nougaret S, Chanques G et al (2011) The absence of adrenal gland enlargement during septic shock predicts mortality: a computed tomography study of 239 patients. Anesthesiology 115:334–343CrossRefPubMed

17.

Tang YZ, Bharwani N, Micco M, Akker S, Rockall AG, Sahdev A (2014) The prevalence of incidentally detected adrenal enlargement on CT. Clin Radiol 69:e37–e42CrossRefPubMed

18.

Schneller J, Reiser M, Beuschlein F et al (2014) Linear and volumetric evaluation of the adrenal gland—MDCT-based measurements of the adrenals. Acad Radiol 21:1465–1474CrossRefPubMed

19.

Wang X, Jin Z-Y, Xue H-D et al (2013) Evaluation of Normal Adrenal Gland Volume by 64-slice CT. Chin Med Sci J 27:220–224CrossRefPubMed

20.

Godoy-Matos AF, Vieira AR, Moreira RO et al (2006) The potential role of increased adrenal volume in the pathophysiology of obesity-related type 2 diabetes. J Endocrinol Invest 29:159–163CrossRefPubMed

21.

Vincent JM, Morrison ID, Armstrong P, Reznek RH (1994) The size of normal adrenal glands on computed tomography. Clin Radiol 49:453–455CrossRefPubMed

22.

Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefPubMed

23.

Cicchetti DV, Sparrow SA (1981) Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior. Am J Ment Defic 86:127–137PubMed

24.

Freel EM, Nicholas RS, Sudarshan T et al (2013) Assessment of the accuracy and reproducibility of adrenal volume measurements using MRI and its relationship with corticosteroid phenotype: a normal volunteer pilot study. Clin Endocrinol (Oxf) 79:484–490CrossRef

25.

Golden SH, Malhotra S, Wand GS, Brancati FL, Ford D, Horton K (2007) Adrenal gland volume and dexamethasone-suppressed cortisol correlate with total daily salivary cortisol in African-American women. J Clin Endocrinol Metab 92:1358–1363CrossRefPubMed

26.

Elahi-Moghaddam Z, Behnam-Rassouli M, Mahdavi-Shahri N, Hajinejad-Boshroue R, Khajouee E (2013) Comparative study on the effects of type 1 and type 2 diabetes on structural changes and hormonal output of the adrenal cortex in male Wistar rats. J Diabetes Metab Disord 12:9–15CrossRefPubMedPubMedCentral

27.

Szigethy E, Conwell Y, Forbes NT, Cox C, Caine ED (1994) Adrenal weight and morphology in victims of completed suicide. Biol Psychiatry 36:374–380CrossRefPubMed

28.

Nemeroff CB, Krishnan KR, Reed D, Leder R, Beam C, Dunnick NR (1992) Adrenal gland enlargement in major depression. A computed tomographic study. Arch Gen Psychiatry 49:384–387CrossRefPubMed

29.

Rubin RT, Phillips JJ, McCracken JT, Sadow TF (1996) Adrenal gland volume in major depression: relationship to basal and stimulated pituitary-adrenal cortical axis function. Biol Psychiatry 40:89–97CrossRefPubMed

30.

Grant LA, Napolitano A, Miller S, Stephens K, McHugh SM, Dixon AK (2010) A pilot study to assess the feasibility of measurement of adrenal gland volume by magnetic resonance imaging. Acta Radiol 51:117–120CrossRefPubMed

31.

Davenport C, Liew A, Doherty B et al (2011) The prevalence of adrenal incidentaloma in routine clinical practice. Endocrine 40:80–83CrossRefPubMed

32.

Prionas ND, Gillen MA, Boone JM (2010) Longitudinal volume analysis from computed tomography: Reproducibility using adrenal glands as surrogate tumors. J Med Phys 35:174–180CrossRefPubMedPubMedCentral

33.

Meier JM, Alavi A, Iruvuri S et al (2007) Assessment of age-related changes in abdominal organ structure and function with computed tomography and positron emission tomography. Semin Nucl Med 37:154–172CrossRefPubMed

34.

Hornsby PJ (2004) Aging of the human adrenal cortex. Sci Aging Knowledge Environ 2004:re6

35.

Commons RR, Callaway CP (1948) Adenomas of the adrenal cortex. Arch Intern Med (Chic) 81:37–41CrossRef

36.

Weber-Hamann B, Hentschel F, Kniest A et al (2002) Hypercortisolemic depression is associated with increased intra-abdominal fat. Psychosom Med 64:274–277CrossRefPubMed

37.

Ludescher B, Najib A, Baar S et al (2007) Gender specific correlations of adrenal gland size and body fat distribution: a whole body MRI study. Horm Metab Res 39:515–518CrossRefPubMed

38.

Epel ES, McEwen B, Seeman T et al (2000) Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosom Med 62:623–632CrossRefPubMed

39.

Roy MS, Roy A, Brown S (1998) Increased urinary-free cortisol outputs in diabetic patients. J Diabetes Complications 12:24–27CrossRefPubMed

40.

Chiodini I, Di Lembo S, Morelli V et al (2006) Hypothalamic–pituitary–adrenal activity in type 2 diabetes mellitus: role of autonomic imbalance. Metabolism 55:1135–1140CrossRefPubMed

41.

Becker HC (2012) Effects of alcohol dependence and withdrawal on stress responsiveness and alcohol consumption. Alcohol Res 34:448–458PubMedPubMedCentral

42.

Ylikahri RH, Huttunen MO, Härkönen M (1980) Hormonal changes during alcohol intoxication and withdrawal. Pharmacol Biochem Behav 13:131–137CrossRefPubMed

43.

Dikić D, Budeč M, Vranješ-Durić S, Koko V, Vignjević S, Mitrović O (2011) The acute effect of ethanol on adrenal cortex in female rats—possible role of nitric oxide. Alcohol 46:523–528

44.

Straub RH, Bijlsma JWJ, Masi A, Cutolo M (2013) Role of neuroendocrine and neuroimmune mechanisms in chronic inflammatory rheumatic diseases—the 10-year update. Semin Arthritis Rheum 43:392–404CrossRefPubMed

45.

Cutolo M, Villaggio B, Foppiani L et al (2000) The hypothalamic–pituitary–adrenal and gonadal axes in rheumatoid arthritis. Ann N Y Acad Sci 917:835–843CrossRefPubMed

Titel: MDCT Linear and Volumetric Analysis of Adrenal Glands: Normative Data and Multiparametric Assessment
verfasst von: Aline Carsin-Vu
Nadia Oubaya
Sébastien Mulé
Annaëlle Janvier
Brigitte Delemer
Philippe Soyer
Christine Hoeffel
Publikationsdatum: 30.10.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4063-y

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