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Differentiation between tuberculosis and primary tumors in the adrenal gland: evaluation with contrast-enhanced CT.
- Source :
-
European radiology [Eur Radiol] 2006 Sep; Vol. 16 (9), pp. 2031-6. Date of Electronic Publication: 2006 Jan 25. - Publication Year :
- 2006
-
Abstract
- The aim of the present study is to determine imaging criteria for differentiating tuberculosis from primary tumors in the adrenal gland on contrast-enhanced CT. Non-contrast and contrast-enhanced CT features in 108 patients with adrenal tuberculosis (n = 34) and primary tumor (n = 74) were retrospectively assessed for the location, size, calcification and enhancement patterns. The primary tumors included 41 adenomas, 11 pheochromocytomas, 4 carcinomas, 3 lymphomas, 6 myelolipomas, 6 ganglioneuromas, 2 neurilemmomas and 1 ganglioneuroblastoma. Biochemical investigation was performed for all patients. Of the tuberculosis cases, 31 (91%) invaded with bilateral involvement, while 7 (9%) of the primary tumors invaded with bilateral involvement (P < 0.001). Tuberculosis often showed calcification (20 of 34; 59%), whereas primary tumors infrequently showed calcification (6 of 74; 8%; P < 0.001). Low attenuation in the center with peripheral rim enhancement was more commonly seen in tuberculosis (16 of 34; 47%) than in primary tumors (7 of 74; 9%; P < 0.001). In the determination of tuberculosis, the highest sensitivity (91%) and accuracy (91%) were obtained with bilateral involvement, and the highest specificity (99%) was obtained with the contour preserved. In the determination of primary tumors using a combination of having unilateral involvement and being mass-like, the outcome was a sensitivity of 91%, specificity of 94% and accuracy of 92%. CT findings can differentiate tuberculosis from a primary tumor of the adrenal glands with high sensitivity and an acceptable specificity when combined with the endocrinological examination.
- Subjects :
- Adolescent
Adult
Aged
Child
Child, Preschool
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Adrenal Gland Neoplasms diagnosis
Contrast Media
Radiographic Image Enhancement methods
Tomography, X-Ray Computed methods
Tuberculosis, Endocrine diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0938-7994
- Volume :
- 16
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 16435135
- Full Text :
- https://doi.org/10.1007/s00330-005-0096-y