title: Prediction of Adrenal Adenomas With Hypercortisolism by Using Adrenal Computed Tomography: Emphasis on Contralateral Adrenal Thinning.
abstract: OBJECTIVE
  To analyze computed tomography (CT) characteristics of adrenal adenomas with hypercortisolism on adrenal CT compared to adenomas with hyperaldosteronism.
  
  
  METHODS
  Thirty-two adrenal adenomas, consisting of group A (hypercortisolism, n = 16) and group B (hyperaldosteronism, n = 16), were evaluated with adrenal CT. Thirty-four patients without adrenal nodule on CT and hormonal abnormality (group C) were selected for comparison. In adenomas, lesion size, attenuation value, and absolute and relative washout were compared between groups A and B. The mean adrenal thickness was compared quantitatively and qualitatively between groups.
  
  
  RESULTS
  All of adenomas satisfied absolute (≥60%) or relative (≥40%) washout criteria of adrenal CT. The mean adrenal thickness was 1.6 ± 0.3 mm in group A, 2.9 ± 0.5 mm in group B, and 3.0 ± 0.4 mm in group C (group A versus B or C, P < 0.001; group B versus C, P = 0.775). For differentiating group A from B, the area under the curve of quantitative and qualitative analyses for contralateral adrenal thickness was 0.982 and 0.934, respectively. Both sensitivity and specificity with cutoff of 2.0 mm or less in thickness and probably thin or more in visual score were 93.7% and 93.7%, and 87.5% and 93.7%, respectively, for predicting group A.
  
  
  CONCLUSIONS
  Contralateral adrenal thinning on CT helps predict adrenal adenomas with hypercortisolism.
authors.affiliation: From the *Department of Radiology and Research Institute of Radiological Science, and †Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Yoon
authors.initials: SY
authors.lastname: Park
authors.forename: Young Taik
authors.initials: YT
authors.lastname: Oh
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Jung
authors.forename: Yumie
authors.initials: Y
authors.lastname: Rhee
mesh_terms: D000302:Adrenal Cortex / Q000000981:diagnostic imaging; D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D018246:Adrenocortical Adenoma / Q000150:complications / Q000000981:diagnostic imaging*; D000328:Adult; D003480:Cushing Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed