Adrenal insidentaloma hastalarının elastografi ile değerlendirilmesi
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Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada amaç, insidentaloma vakalarında adrenal bezin sonoelastografik özelliklerini ortaya koymak, insidentaloma tanısı alan ve kesitsel incelemelerde tanı konulan adrenal kitlelerin elastografi özelliklerini belirlemek ve ultrasonografi (US) incelemede fark edilen adrenal kitlelerin ileri tetkiklere gerek kalmadan sonoelastografi ile adenom tanısını konulmasını sağlamaktır. Çalışmaya Kırıkkale Üniversitesi Tıp Fakültesi etik kurul onayı ile başlanmıştır. Prospektif kesitsel bir çalışma olarak planlanmıştır. Çalışmaya Haziran 2022-Şubat 2023 tarihleri arasında İç Hastalıkları Endokrinoloji Polikliniğine başvuran ve hastane PACS (Picture Archiving and Communication Systems) sisteminde bilgisayarlı tomografi (BT) görüntüsü bulunan 42 hasta dahil edilmiş olup toplam 46 adrenal lezyon strain elastografi ile değerlendirilmiştir. Adrenal lezyon komşuluğunda karaciğer, böbrek ve dalak parankimi strain elastografi ile değerlendirilmiştir. Hastaların serum kortizol, serum DHEA-S (dehidroepiandrosteron sülfat), serum aldosteron, idrar metanefrin ve idrar VMA (vanil mandelik asit) değerlerine bakılmıştır. İstatistiksel analizler yapılırken IBM SPSS 21.0 paket programı kullanılmıştır. İstatistiksel anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Toplam 42 hastamızın 32'si kadın, 10'u erkek ve ortalama tanı yaşı 55,9'du. Adrenal insidentalomaların 37'si adenom, 6'sı myelolipom, 1'i kist, 1'i indeterminate ve 1'i metastazdı. Lezyonların 26'sı sağ, 12'si sol, 4'ü bilateral yerleşimli ve kitle uzun aks ortalaması 26,1 mm'di. Adrenal lezyon tiplerinin strain elastografi değerleri ve renk skala değerleri arasında istatistiksel olarak anlamlı ilişki saptanmadı (p>0,05). Adrenal lezyon strain elastografi ile lezyon boyutu ve komşu parankim elastografi değerleri arasında istatistiksel anlamlı ilişki bulunmadı (p>0,05). Laboratuvar değerlerinin lezyon strain elastografi değerleri ve karaciğer, böbrek, dalak parankim elastografi değerleri arasında istatistiksel anlamlı ilişki saptanmadı (p>0,05). Çalışmamızda, adrenal insidentalomalarda tanı yaşı, cinsiyet dağılımı ve kitle lokalizasyonu ile ilgili verilerimizin literatür ile uyumlu olduğunu tespit ettik. Adrenal lezyonların strain elastografi ile değerlendirilmesinde renk skala değerleri ve elastografi değerleri arasında anlamlı ilişki saptamadık. Literatürde bu konu ile ilgili çalışmalar sınırlı olduğundan dolayı, çalışmamızda elde edilen veriler gelecekteki araştırmalar için bir referans olarak kullanılabilir. Elastografi tekniğinin referans değerlerini ve tekrarlanabilirliğini belirlemek için çok merkezli ve daha fazla hasta grupları içeren prospektif çalışmalara ihtiyaç vardır.
The aim of this study is to reveal the sonoelastographic features of the adrenal gland in incidentaloma cases, to determine the elastography features of adrenal masses diagnosed as incidentaloma and diagnosed in cross-sectional examinations and it is to provide the diagnosis of adenoma by sonoelastography of adrenal masses detected in ultrasound (US) examination without the need for further investigations. The study was initiated with the approval of the ethics committee of Kırıkkale University Faculty of Medicine. The study was intended to be prospective and cross-sectional. The study included 42 patients who applied to the Internal Medicine Endocrinology Polyclinic between June 2022 and February 2023 and had a computed tomography (CT) image in the hospital PACS (Picture Archiving and Communication Systems) system and a total of 46 adrenal lesions were evaluated by strain elastography. Liver, kidney and spleen parenchyma adjacent to the adrenal lesion were evaluated with strain elastography. Serum cortisol, serum DHEA-S (dehydroepiandrosterone sulfate), serum aldosterone, urinary metanephrine and urinary VMA (vanillylmandelic acid) values of the patients were measured. IBM SPSS 21.0 package program was used for statistical analysis. Statistical significance level was accepted as p<0.05. Of our 42 patients, 32 were female, 10 were male, and the mean age at diagnosis was 55.9 years. Of the adrenal incidentalomas, 37 were adenomas, 6 were myelolipomas, 1 was cyst, 1 was indeterminate, and 1 was metastasis. Twenty-six of the lesions were located on the right, 12 on the left, and 4 were bilaterally located, and the mass long axis average was 26.1 mm. No statistically significant correlation was found between strain elastography values and color scale values of adrenal lesion types (p>0.05). No statistically significant correlation was found between adrenal lesion strain elastography and lesion size and adjacent parenchymal elastography values (p>0.05). No statistically significant correlation was found between lesion strain elastography values and liver, kidney and spleen parenchymal elastography values of laboratory values (p>0.05). In our study, we found that our data on age at diagnosis, gender distribution and mass localization in adrenal incidentalomas were consistent with the literature. We did not find a significant relationship between color scale values and elastography values in the evaluation of adrenal lesions with strain elastography. Since studies on this subject are limited in the literature, the data obtained in our study can be used as a reference for future research. Multicenter prospective studies with larger patient groups are needed to determine the reference values and reproducibility of the elastography technique.
The aim of this study is to reveal the sonoelastographic features of the adrenal gland in incidentaloma cases, to determine the elastography features of adrenal masses diagnosed as incidentaloma and diagnosed in cross-sectional examinations and it is to provide the diagnosis of adenoma by sonoelastography of adrenal masses detected in ultrasound (US) examination without the need for further investigations. The study was initiated with the approval of the ethics committee of Kırıkkale University Faculty of Medicine. The study was intended to be prospective and cross-sectional. The study included 42 patients who applied to the Internal Medicine Endocrinology Polyclinic between June 2022 and February 2023 and had a computed tomography (CT) image in the hospital PACS (Picture Archiving and Communication Systems) system and a total of 46 adrenal lesions were evaluated by strain elastography. Liver, kidney and spleen parenchyma adjacent to the adrenal lesion were evaluated with strain elastography. Serum cortisol, serum DHEA-S (dehydroepiandrosterone sulfate), serum aldosterone, urinary metanephrine and urinary VMA (vanillylmandelic acid) values of the patients were measured. IBM SPSS 21.0 package program was used for statistical analysis. Statistical significance level was accepted as p<0.05. Of our 42 patients, 32 were female, 10 were male, and the mean age at diagnosis was 55.9 years. Of the adrenal incidentalomas, 37 were adenomas, 6 were myelolipomas, 1 was cyst, 1 was indeterminate, and 1 was metastasis. Twenty-six of the lesions were located on the right, 12 on the left, and 4 were bilaterally located, and the mass long axis average was 26.1 mm. No statistically significant correlation was found between strain elastography values and color scale values of adrenal lesion types (p>0.05). No statistically significant correlation was found between adrenal lesion strain elastography and lesion size and adjacent parenchymal elastography values (p>0.05). No statistically significant correlation was found between lesion strain elastography values and liver, kidney and spleen parenchymal elastography values of laboratory values (p>0.05). In our study, we found that our data on age at diagnosis, gender distribution and mass localization in adrenal incidentalomas were consistent with the literature. We did not find a significant relationship between color scale values and elastography values in the evaluation of adrenal lesions with strain elastography. Since studies on this subject are limited in the literature, the data obtained in our study can be used as a reference for future research. Multicenter prospective studies with larger patient groups are needed to determine the reference values and reproducibility of the elastography technique.
Açıklama
Tıp Fakültesi, Radyoloji Ana Bilim Dalı
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine
