Adrenal Masses: Characterization with Combined Unenhanced and Delayed Enhanced CT

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 nonadenoma 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 nonadenomas 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 nonadenomas.

© RSNA, 2002


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Article History

Published in print: Mar 2002