Distinction between benign and malignant adrenal masses: value of T1-weighted chemical-shift MR imaging
| Autor: | E S Siegelman, C W Piccoli, Donald G. Mitchell, Eric K. Outwater, P D Radecki |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Adrenal Gland Neoplasms Sensitivity and Specificity Diagnosis Differential Adrenal masses Flip angle Confidence Intervals T1 weighted Humans Medicine Radiology Nuclear Medicine and imaging Adrenal lesion Aged Observer Variation business.industry General Medicine Benign lesion Middle Aged Probable diagnosis Magnetic Resonance Imaging Mr imaging Predictive value Female Nuclear medicine business Follow-Up Studies |
| Zdroj: | American Journal of Roentgenology. 165:579-583 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.165.3.7645474 |
| Popis: | Accuracy of T1-weighted chemical-shift MR imaging for the differentiation between benign and malignant adrenal masses was blindly assessed among three radiologists.MR imaging was performed at 1.5 T in 50 patients with 58 adrenal masses, proved benign (n = 38) or malignant (n = 20) based on surgery or growth (malignant) or stable size (benign) for at least 1 year. In-phase spin-echo sequences or in-phase breath-hold fast multiplanar spoiled gradient-recalled echo (FMPSPGR) sequences with a TE of 4.2 msec were compared with opposed-phase breath-hold FMPSPGR sequences with a TR/TE of 35-155/2.2-2.9 and a 90 degrees flip angle for the detection of lipid in adrenal masses. Three radiologists who were blinded to diagnosis and clinical data independently rated the likelihood of a benign adrenal lesion on a five-point scale of confidence.Mean sensitivity, specificity, and positive predictive value for a definite or probable diagnosis of a benign lesion by the three readers were 87%, 92%, and 95%, respectively. At the highest (definite) confidence of a benign lesion, the mean positive predictive value was 99%, with lower sensitivity (54%). Areas under receiver operating characteristic curves for the three radiologists were .98 (95% confidence interval [CI] = .94-1.00), .96 (CI = .91-1.00), and .95 (CI = .89-1.00). Interobserver variation for the diagnosis of a benign mass was low (kappa = .79).Chemical-shift imaging using breath-hold opposed-phase T1-weighted MR images is a reliable and reproducible technique for the diagnosis of most benign adrenal masses at the highest threshold of confidence. |
| Databáze: | OpenAIRE |
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