Addison's disease due to adrenal tuberculosis: contrast-enhanced CT features and clinical duration correlation.
OBJECTIVE
To describe CT morphology of untreated adrenal tuberculosis during the different stages of the natural history of the disease and to evaluate the diagnostic implications of CT features.


METHODS
We retrospectively evaluated CT features in 42 patients with documented adrenal tuberculosis for the location, size, morphology, and enhancement patterns shown on CT images. The clinical duration were correlated with the CT features.


RESULTS
Of the 42 patients with untreated adrenal tuberculosis, bilaterally enlarged adrenal glands were revealed in 38 cases (91%), unilaterally enlarged in 3 cases (7%), and normal size in 1 case (2%). Of the 41 cases (98%) with enlargement, mass-like enlargement was seen in 20 cases (49%) and enlargement with preserved contours in 21 cases (51%). Peripheral rim enhancement presented in 22 cases (52%) on contrast-enhanced CT. Non-enhanced CT scan revealed calcification in 21 cases (50%). As the duration of Addison's disease increased, the presence of calcification and contour preservation increased concomitantly (p<0.001), whereas peripheral rim enhancement and mass-like enlargement decreased concomitantly on CT images (p<0.001).


CONCLUSIONS
CT may be helpful in diagnosing adrenal tuberculosis when clinically suspected, and CT features are correlated to the clinical duration of Addison's disease.
Guo
Ying-Kun
YK
Department of Radiology, West China Hospital, Sichuan University, #37 Guo Xue Xiang, Chengdu, Sichuan 610041, China.
Yang
Zhi-Gang
ZG
Li
Yuan
Y
Ma
En-Sen
ES
Deng
Yu-Ping
YP
Min
Peng-Qiu
PQ
Yin
Long-Lin
LL
Hu
Jian
J
Zhang
Xiao-Chun
XC
Chen
Tian-Wu
TW
D000224:Addison Disease / Q000000981:diagnostic imaging* / Q000382:microbiology*; D000307:Adrenal Gland Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D003287:Contrast Media; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D016014:Linear Models; D008875:Middle Aged; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014383:Tuberculosis, Endocrine / Q000150:complications* / Q000000981:diagnostic imaging*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide