RESUMEN
BACKGROUND: In most cases adrenal tumours are detected by accident while performing medical imaging tests for other diseases. These findings are treated as adrenal incidentaloma. Prevalence of incidentalomas detected on CT scans is up to 4%. According to different authors, 4-12% of all adrenal tumours are adrenocortical carcinomas. As for today, the most significant medical imaging technique is CT scan with bolus IV injection of contrast agent and assessment of tumour's density. The analysis of the results of CT imaging in 67 patients with ACC was carried out according to a single protocol. The main signs characteristic of this disease are described. It is very important to evaluate typical signs of ACC on CT scans for risk assessment of ACC before surgical treatment. If malignant tumour is suspected during preoperative examination, it is extremely important to choose the right surgical treatment strategy. AIM: To evaluate the significance of CT as the main method of preoperative diagnosis in patients with malignant tumors of the adrenal cortex. Studying CT semiotics of adrenocortical cancer in a large group of patients using a single standard imaging protocol. Find the main radiological symptoms characteristic of adrenocortical cancerMATERIALS AND METHODS: Here are the results of retrospective study of CT scans performed on 67 patients with adrenocortical carcinoma who received treatment in the Department of Endocrine Surgery of Saint-Petersburg State University N.I. Pirogov Clinic of High Medical Technologies during 2012-2020. The diagnostic significance of CT in patients with ACC was assessed. RESULTS: The most common features of ACC: tumour heterogeneity (84.3%), tumour's size 3-9 cm (75%), signs of invasion into surrounding structures (10%), pre-contrast density above +30 HU (75%), absolute contrast washout less than 60% (68.8%), relative contrast washout less than 40% (64.6%)CONCLUSION: CT scan with IV contrast was not able to show any definitive pathognomonic signs of ACC. Nevertheless, CT scan should be performed in all patients with suspected (or confirmed using other medical imaging technique) adrenal tumour according to standard protocol. Bolus injection of contrast agent should be performed in all patients with tumour's pre-contrast density above +5 HU.
Asunto(s)
Neoplasias de la Corteza Suprarrenal , Neoplasias de las Glándulas Suprarrenales , Carcinoma Corticosuprarrenal , Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Carcinoma Corticosuprarrenal/diagnóstico por imagen , Carcinoma Corticosuprarrenal/terapia , Medios de Contraste , Humanos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/métodosRESUMEN
The aim of the investigation was an assessment of potentials of computed-tomography colonography (CTC) in diagnosis of diseases of the colon. CTC was made in 125 patients. The investigation was performed after special preparation of the patients for purgation of the colon. The patient was in the supine and prone position. After introduction of room air in the colon the axial sections were laid from the diaphragm cupola to the pelvic floor. The obtained data were estimated and the reconstructions were fulfilled using special software. Pathological alterations or anatomical specific features of the colon were detected in 86 out of 125 cases (68.8%), in 26 of the cases (28.6%) a conclusion was made of malignant tumors in the colon according to the data of CTC. The data obtained by CTC were compared with the data of fibrocolonoscopy, rectomanoscopy, irrigoscopy and histological investigation. In most cases the coincidence of the findings was noted.