Distinguishing adrenal adenomas from non-adenomas on dynamic enhanced CT: a comparison of 5 and 10 min delays after intravenous contrast medium injection

Clin Radiol. 2013 Jul;68(7):696-703. doi: 10.1016/j.crad.2013.01.016. Epub 2013 Mar 5.

Abstract

Aim: To evaluate the usefulness of several parameters of 5 min compared to 10 min delayed contrast-enhanced CT in distinguishing adenomas from non-adenomas.

Materials and methods: The study population consisted of 94 patients (52 men and 42 women; mean age 62 years) with 103 adrenal lesions (75 adenomas and 28 non-adenomas). In each patient, unenhanced CT was followed by early, 5 and 10 min enhanced CT. Diagnostic parameters included delayed enhanced attenuation at 5 and 10 min, washout attenuation (WO) at 5 and 10 min, absolute percentage washout (APW) at 5 and 10 min, and relative percentage washout (RPW) at 5 and 10 min. The accuracy of each parameter for diagnosing adenomas from non-adenomas was calculated using receiver operating characteristic (ROC) analysis.

Results: Upon comparison between 5 and 10 min delayed contrast-enhanced CT for differentiating total adenomas or lipid-poor adenomas from non-adenomas, there was no significant difference in the area under the binomial ROC curve (Az) values of delayed enhanced attenuation (total adenomas versus non-adenomas, p = 0.164; lipid-poor adenomas versus non-adenomas, p = 0.178), WO (total adenomas versus non-adenomas, p = 0.216; lipid-poor adenomas versus non-adenomas, p = 0.230), APW (total adenomas versus non-adenomas, p = 0.401; lipid-poor adenomas versus non-adenomas, p = 0.870), or RPW (total adenomas versus non-adenomas, p = 0.160; lipid-poor adenomas versus non-adenomas, p = 0.780).

Conclusion: Five minute contrast-enhanced CT was as useful as 10 min contrast-enhanced CT for differentiation of adrenal adenomas from non-adenomas.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adenoma / diagnostic imaging*
  • Adrenal Gland Neoplasms / diagnostic imaging*
  • Adrenal Gland Neoplasms / secondary
  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media* / administration & dosage
  • Diagnosis, Differential
  • Female
  • Humans
  • Injections, Intravenous
  • Iodine / administration & dosage
  • Lymphoma / diagnostic imaging
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods
  • Neurofibroma / diagnostic imaging
  • Pheochromocytoma / diagnostic imaging
  • Retrospective Studies
  • Time Factors

Substances

  • Contrast Media
  • Iodine