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Adrenal masses: characterization with combined unenhanced and delayed enhanced CT
Elaine M Caoili1, Melvyn Korobkin, Isaac R Francis
1Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109-9723, USA. caoili@umich.edu
Purpose:
To assess the accuracy of a dedicated adrenal computed tomographic (CT) protocol.
Materials And Methods:
One hundred sixty-six adrenal masses were evaluated with a protocol consisting of unenhanced CT, and, for those with attenuation values greater than 10 HU, contrast material-enhanced and delayed enhanced CT. Attenuation values and enhancement washout calculations were obtained. An adenoma was diagnosed if a mass had an attenuation value of 10 HU or less at unenhanced CT or a percentage enhancement washout value of 60% or higher.
Results:
The final diagnosis was adenoma in 127 masses and non-adenoma in 39. Masses measuring more than 10 HU on unenhanced CT scans were confirmed at biopsy (n = 28) or were examined for stability or change in size at follow-up CT performed at a minimum interval of 6 months (n = 33). Thirty-six (92%) of 39 non-adenomas and 124 (98%) of 127 adenomas were correctly characterized. The sensitivity and specificity of this protocol were 98% and 92%, respectively. This protocol correctly characterized 160 (96%) of 166 masses.
Conclusion:
With a combination of unenhanced and delayed enhanced CT, nearly all adrenal masses can be correctly categorized as adenomas or non-adenomas.