Analysis of 23 Cases of Adrenal Tuberculosis on MRI Features
Objective To observe the MRI features of adrenal tuberculosis and evaluate the value of MRI in the diagnosis of this disease.Methods MRI features of 23 patients with adrenal tuberculosis(case group)confirmed by pathology and 23 patients with adrenal metastatic tumor(control group)were compared and retrospectively analyzed.Results Among case group,42 glands were revealed in these 23 patients with unilateral lesion(n=4)and bilateral lesions(n=19).Forty glands were enlarged,while two was atrophic.Of the 40 enlarged glands,23 were mass-like and 17 had preserved contours.49 lesions were revealed in these 23 patients.The length of the lesion ranged from 0.9 to 4.9cm.The solid mass lesion demonstrated homogeneous hypo-or iso-SI on T1WI,and the signal intensity was hypo-or hyper-SI on T2WI,with few spot shape hypointense signal.The lesions demonstrated slightly hypointense,isointense or hyperintense signal on DWI.In contrast,there were 7 homogeneous enhancement and 40 inhomogeneous enhancement,including ring enhancement and septal enhancement.The range of parenchymal components of the lesions was enlarged by delayed scan,and 2 lesions no enhancement.The solid part of the lesions showed progressive enhancement on delayed phase.The ADC of the solid nodules and ring wall of adrenal tuberculosis were(1.28±0.26)×10-3mm2/s、(1.06±0.10)×10-3mm2/s,they were higher than that of the adrenal metastases.The ADC of caseous solid center of ring enhancing lesions in adrenal tuberculosis was(1.23±0.16)×10-3mm2/s,it was lower than that of the necrosis center of adrenal metastases.Conclusion MRI could reflect certain pathological changes of adrenal tuberculosis and be used to assess the activity of tuberculosis.
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