VAI TRÒ CỦA CỘNG HƯỞNG TỪ TRONG CHẨN ĐOÁN U TUYẾN THƯỢNG THẬN

SAMMARY

Purpose: to evaluate the role of MRI in diagnosis adrenal tumors.

Subject and methods: our cross–sectional descriptive study included 25 patients who were diagnosed as adenoma hyperplasia in pathology. All patients underwent MRI examination in Bach Mai hospital from June, 2020 to July, 2021.

Results: mean age of all patient was 49,2±11,8. Male/female ratio was 1.5/1. 25 adrenal tumor on MRI and identified on the diagnosed as adenoma hyperplasia in pathology. These adenomas consisted 12 adrenal cortical adenoma (ACA) and 13 non – adrenal cortical adenoma (NACA): 09 pheochromocytomas, 01 adrenocortical carcinoma, 01 ganglioneuroma and 02 myelolipoma. Mean size of all adrenal tumors was 38,8 ± 23,5mm, therein, mean size of ACA group and NACA group was 23,2 ± 7,6 mm and 52,2 ± 25,7 mm respectively. Chemical Shift Imaging (CSI) allowed differential diagnose between ACA and NACA. Qualitative analysis based on signal reduction on out – phase compared to in – phase allows 11/12 ACA, but 2/13 NACA have been misdiagnosed as ACA. Quantitative analysis based on SII index (SII threshold > 16,1%) allowed correctly diagnose 11/12 ACA and 01 NACA. ASR index (ASR threshold <0,71) allowed correctly diagnose 11/12 ACA and 01 NACA. There are 02 adrenal tumors that invaded to the surrounding area in imaging and was demonstrated by surgery and pathology reports.

Conclusion: MRI has an important role in adrenal mass diagnosis with sensitivity and specificity were 100% and 96,1% respectively. CSI enable to distinguish ACA and NACA with sensitivity and specificity were 91,7% and 92,3% respectively by using SII and ASR index. MRI also help to assess invasive and metastatic properties with high accuracy.

Key words: adrenal tumors, adrenal MRI, chemical shift imaging (CSI).