title: Application of parametric ultrasound contrast agent perfusion studies for differentiation of hyperplastic adrenal nodules from adenomas-Initial study.
abstract: OBJECTIVE
  To evaluate the possibilities of differentiation of non-malignant adrenal masses with the application of the new technique for the evaluation of enhancement after administration of an ultrasound contrast agent: parametric imaging.
  
  
  METHODS
  34 non-malignant adrenal masses in 29 patients were evaluated in a dynamic examination after the administration of ultrasound contrast agent with parametric imaging. Patterns on parametric imaging of arrival time were evaluated. The final diagnosis was based on CT, MRI, biochemical studies, follow up and/or histopathology examination.
  
  
  RESULTS
  The study included: 12 adenomas, 10 hyperplastic nodules, 7 myelolipomas, 3 pheochromocytomas, hemangioma with hemorrhage and cyst. The pattern of peripheral laminar inflow of Sonovue on parametric images of arrival time of was 100% sensitive for hyperplastic nodules and 83% specific in regard to adenomas.
  
  
  CONCLUSIONS
  Parametric contrast enhanced ultrasound may accurately differentiate hyperplastic adrenal nodules from adenomas and could be complementary to CT or MRI. Incorporation of perfusion studies to CT or MRI could possibly enable one-shop complete characterization of adrenal masses. This could deliver additional information in diagnostics of patients with Conn Syndrome and warrants further studies in this cohort of patients.
authors.affiliation: Diagnostic Imaging Department, Medical University of Warsaw, Second Faculty of Medicine with English and Physiotherapy Divisions, Warsaw, Poland. Electronic address: rz.slapa@gmail.com.
authors.forename: Rafal Z
authors.initials: RZ
authors.lastname: Slapa
authors.affiliation: Endocrinology Department, Center for Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland.
authors.forename: Anna A
authors.initials: AA
authors.lastname: Kasperlik-Zaluska
authors.affiliation: Diagnostic Imaging Department, Medical University of Warsaw, Second Faculty of Medicine with English and Physiotherapy Divisions, Warsaw, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Migda
authors.affiliation: Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, First Faculty of Medicine, Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Otto
authors.affiliation: Diagnostic Imaging Department, Medical University of Warsaw, Second Faculty of Medicine with English and Physiotherapy Divisions, Warsaw, Poland.
authors.forename: Wiesław S
authors.initials: WS
authors.lastname: Jakubowski
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000311:Adrenal Glands / Q000000981:diagnostic imaging* / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D006801:Humans; D006965:Hyperplasia; D007089:Image Enhancement / Q000379:methods*; D010743:Phospholipids; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: Adrenal gland diseases; Adrenal hyperplasia; Perfusion imaging; Ultrasound