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Background <p>To explore the stratification and identification of adrenal lipid-poor adenomas (LPAs), adrenal cysts (ACs), and adrenal ganglioneuromas (AGNs) from each other <i>using contrast-enhanced</i> computed tomography (<i>CT)</i>.</p> Methods <p>Pathologically confirmed, 348 patients were categorized into Model 1 (260 LPAs, 34 ACs), Model 2 (260 LPAs, 54 AGNs), and Model 3 (34 ACs, 54 AGNs). Statistical analyses were performed on the differences in the degree of enhancement in the arterial/venous phase (DEap/DEvp) (in HU) and the corresponding graded variables for the arterial/venous phase (GVap/GVvp). Models were evaluated via receiver operating characteristic (ROC) curves, calibration curves, and the Hosmer‒Lemeshow (HL) test.</p> Results <p>The values of the area under the curve (AUC) for DEap, DEvp, GVap, and GVvp in Models 1–3 were 0.996, 1.000, 0.993, and 0.999; 0.980, 0.978, 0.961, and 0.975; and 0.734, 0.892, 0.725, and 0.883, respectively. The p values of the HL test were 0.984, 1.000, and 0.113, respectively. The DEvp interval values (in HU) for the LPAs, ACs, and AGNs were [4.9, 190.2] HU, [-3.7, 4.2] HU, and [-4.8, 41.8] HU, respectively. The GVap and GVvp ranges for the LPAs, ACs, and AGNs were [1, 6], [0, 2], and [0, 2] and [1, 6], [0, 1], and [0, 5], respectively.</p> Conclusions <p>DEvp enhanced discrimination in Models 1 and 3, whereas DEap performed better in Model 2. Lesions with DEvp &lt; 4.5 HU are likely represent non-enhancing pathology (e.g., cysts). When both GVap and GVvp are 0, when both GVap and GVvp are [2, 6], and when GVap is [3, 6] and GVvp is 6, LPA, AC, and AGN are excluded.</p> Clinical trial number <p>Not applicable.</p>

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New heights in CT differentiation of adrenal lesions and a rational definition of non-enhancement

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月26日

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  • Lichun Liu,
  • Fangmei Zhu,
  • Zongfeng Niu,
  • Zongyu Xie,
  • Dengfa Yang,
  • Jian Wang,
  • Cheng Yan

摘要

Background

To explore the stratification and identification of adrenal lipid-poor adenomas (LPAs), adrenal cysts (ACs), and adrenal ganglioneuromas (AGNs) from each other using contrast-enhanced computed tomography (CT).

Methods

Pathologically confirmed, 348 patients were categorized into Model 1 (260 LPAs, 34 ACs), Model 2 (260 LPAs, 54 AGNs), and Model 3 (34 ACs, 54 AGNs). Statistical analyses were performed on the differences in the degree of enhancement in the arterial/venous phase (DEap/DEvp) (in HU) and the corresponding graded variables for the arterial/venous phase (GVap/GVvp). Models were evaluated via receiver operating characteristic (ROC) curves, calibration curves, and the Hosmer‒Lemeshow (HL) test.

Results

The values of the area under the curve (AUC) for DEap, DEvp, GVap, and GVvp in Models 1–3 were 0.996, 1.000, 0.993, and 0.999; 0.980, 0.978, 0.961, and 0.975; and 0.734, 0.892, 0.725, and 0.883, respectively. The p values of the HL test were 0.984, 1.000, and 0.113, respectively. The DEvp interval values (in HU) for the LPAs, ACs, and AGNs were [4.9, 190.2] HU, [-3.7, 4.2] HU, and [-4.8, 41.8] HU, respectively. The GVap and GVvp ranges for the LPAs, ACs, and AGNs were [1, 6], [0, 2], and [0, 2] and [1, 6], [0, 1], and [0, 5], respectively.

Conclusions

DEvp enhanced discrimination in Models 1 and 3, whereas DEap performed better in Model 2. Lesions with DEvp < 4.5 HU are likely represent non-enhancing pathology (e.g., cysts). When both GVap and GVvp are 0, when both GVap and GVvp are [2, 6], and when GVap is [3, 6] and GVvp is 6, LPA, AC, and AGN are excluded.

Clinical trial number

Not applicable.