Significado de la visualización de la vena central de la glándula suprarrenal en la tomografía computarizada con contraste intravenoso.

Abstract

Routine CT studies for different causes detect adenomatous lesions as an incidental finding in a significant percentage of the studies. A common clinical situation is the detection of an adrenal nodule in a routine thoracic or abdominal study with intravenous contrast performed in the venous phase (approximately 70 seconds after injection), therefore establishing the diagnosis of adenoma in this this type of examination is difficult since the image characteristics overlap with those of metastases and other adrenal lesions. Based on the Weiss pathological criteria in which it is established that the absence of venous vascular invasion is a benign criterion of an adrenal lesion, this thesis aims to establish the positive predictive value of visualization of the central vein of the adrenal gland in the Intravenous contrast-enhanced CT to correspond to a benign adrenal lesion in patients undergoing exploration for any reason. For this, the presence of this radiological sign has been determined in a group of 100 adrenal lesions identified in routine studies. On the other hand, a group of 90 lesions observed in routine studies in which the central vein of the adrenal gland was visualized on CT with intravenous contrast were selected, correlating them with their final diagnosis confirmed by their evolution or histological study. Visualization of the central vein of the adrenal gland showed a prevalence of 61% and offered a sensitivity of 66%, a specificity of 80%, a predictive positive value of 97% and a negative predictive value of 21% for the diagnosis of adenomatous lesion. Visualization of the central vein of the adrenal gland in incidental adrenal lesions offers a high predictive positive value that these lesions are adenomatous, both in oncological and non-oncological patients, however, the absence of visualization of the central vein of the adrenal gland it does not allow to determine the nature of the lesion.

Date of Award	25 Nov 2020
Original language	Spanish
Supervisor	Jose Alberto Hidalgo Perez (Director), Alberto Flotats Giralt (Director), Antonio Moral Duarte (Director) & Ignaci Carrio Gasset (Tutor)