LIPID-POOR ADRENAL MASSES: EVAL W/ DUAL ECHO CHEMICAL SHIFT MR IMAGING

缺乏脂质的肾上腺肿块：使用双回波化学位移 MR 成像进行评估

• 批准号: 7603754
• 负责人: GISELA C MUELLER
• 金额: $ 0.18万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2007-09-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7603754
• 关键词: Abdomen; Address; Adrenal Gland Adenoma; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Mass; Age; Age-Years; Benign; Chemicals; Computer Retrieval of Information on Scientific Projects Database; Consensus; Contrast Media; Detection; Diagnosis; Diagnostic; Diagnostic Procedure; Dose; Exposure to; Fatty acid glycerol esters; Funding; General Population; Grant; Hypersensitivity; Image; Imaging Device; Imaging Techniques; Impairment; Incidence; Institution; Intravenous; Ionizing radiation; Kidney; Left; Lesion; Lipids; MRI Scans; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Measurement; Methods; Morphologic artifacts; Patients; Publishing; Recording of previous events; Recruitment Activity; Renal function; Research; Research Personnel; Resources; Risk; Scanning; Signal Transduction; Source; Subgroup; Techniques; Tissues; United States National Institutes of Health; Unnecessary Surgery; Water; Woman; X-Ray Computed Tomography; adenoma; men; nephrotoxicity; tumor

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Tumors of the adrenal glands are common in the general population. As a result of the widespread use of cross sectional imaging techniques, such tumors are often incidentally detected. Adrenal tumors are found in approximately 0.35% - 4.36% of patients who undergo CT imaging for reasons unrelated to the adrenal glands, and the incidence of these tumors increases with age. The majority of adrenal tumors are harmless, and can be left alone. Therefore, it is necessary to characterize these tumors to avoid unnecessary surgery or diagnostic procedures. Benign adrenal tumors will be further referred to as "adrenal adenomas". Many adrenal adenomas can be easily identified on computed tomography without the use of intravenous contrast material, by demonstrating their fat content. Fat is typically seen in benign adrenal tumors and is rare in malignant adrenal lesions. There is, however, a subgroup of adrenal adenomas, the so-called lipid poor adrenal adenomas, whose fat content is too low to be easily detected. Such lesions pose a serious diagnostic problem, especially in patients with history of malignancy. Definitive characterization of such lesions is often achieved with contrast enhanced CT, which involves exposure to ionizing radiation and the risks associated with the use of iodinated contrast medium. Such risks include possible contrast allergy and toxic impairment of marginally functioning kidneys. Iodinated contrast related kidney impairment is kidney function and contrast dose dependent. MR imaging is an effective alternative method for characterizing adrenal masses. It does not involve ionizing radiation or use of intravenous iodinated contrast material. A technique called chemical shift is used in MR imaging to characterize adrenal lesions. This technique exploits imaging the additive and subtracted signal of fat and water in a volume of tissue. While chemical shift MR imaging is as good as non-contrast CT for diagnosing adenomas with high fat content, there is no consensus regarding its utility for characterizing adrenal adenomas with minimal fat content that cannot be characterized by non-contrast CT. This in part is due to the outdated techniques used in older studies addressing this subject. Technical advances in MR imaging with the use of specialized coils for abdominal imaging, and new sequences, allow detection of small amounts of fat in adrenal lesions. A new MRI sequence called the Dual Echo gradient echo, which can be acquired in a single breath-hold, helps eliminate potential sources for imprecise measurements of fat in adrenal tumors, such as misregistration artifacts. So far, no studies have been published to evaluate the accuracy of dual echo chemical shift MR imaging for characterizing lipid poor adrenal lesions. We plan to recruit men and women 18 years of age or older with adrenal masses who have undergone a dedicated CT of the adrenal gland. These patients will undergo an MRI scan, usually 15-20 minute scan without intravenous contrast. If dual echo chemical shift MR imaging proves to be an accurate imaging tool for identifying adrenal adenomas with low fat content that cannot be reliably identified by non-contrast CT, patients will benefit from the advantages of this imaging method including the lack of ionizing radiation, and absence of risk of nephrotoxicity and allergy to iodinated intravenous contrast material.'

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 肾上腺的肿瘤在普通人群中很常见。由于广泛使用了横截面成像技术，通常会偶然检测到此类肿瘤。肾上腺肿瘤大约在0.35％-4.36％进行CT成像的患者出于与肾上腺无关的原因，并且这些肿瘤的发生率随着年龄的增长而增加。 大多数肾上腺肿瘤是无害的，可以独自一人。因此，有必要表征这些肿瘤，以避免不必要的手术或诊断程序。良性肾上腺肿瘤将进一步称为“肾上腺腺瘤”。通过证明其脂肪含量，可以轻松地在计算机断层扫描上轻松识别许多肾上腺腺瘤。脂肪通常在良性肾上腺肿瘤中看到，在恶性肾上腺病变中很少见。但是，有一个肾上腺腺瘤的亚组，即所谓的脂质较差的肾上腺腺瘤，其脂肪含量太低，无法轻易检测到。这种病变是一个严重的诊断问题，尤其是在有恶性肿瘤史的患者中。这种病变的明确表征通常通过增强的CT来实现，这涉及暴露于电离辐射以及与使用碘化对比介质有关的风险。这种风险包括可能的对比度过敏和有毒的肾脏损伤。碘对比相关的肾脏损伤是肾功能和对比剂量依赖性。 MR成像是表征肾上腺肿块的有效替代方法。它不涉及电离辐射或静脉内碘对比材料的使用。 MR成像中使用了一种称为化学移位的技术来表征肾上腺病变。该技术利用在组织体积中成像脂肪和水的添加和减去信号。虽然化学转移MR成像与非对比度CT一样好，用于诊断脂肪含量高的腺瘤，但就其表征具有最小脂肪含量的肾上腺腺瘤的实用性尚无共识，而这些脂肪含量最小，而这些脂肪含量最小，而这些脂肪含量最小。这部分是由于针对该主题的旧研究中使用的过时技术。 使用专门的线圈进行腹部成像和新序列，MR成像的技术进步允许在肾上腺病变中检测少量脂肪。一个称为双回声梯度回声的新的MRI序列可以在单个呼吸中获取，有助于消除潜在的来源，以使肾上腺肿瘤中脂肪的测量不精确，例如误导伪影。到目前为止，尚未发表研究以评估双回声化学转移MR成像的准确性，以表征脂质较差的肾上腺病变。我们计划招募18岁或以上的男性和女性，患有肾上腺专用CT的肾上腺肿块。这些患者将接受MRI扫描，通常不会在没有静脉造影的情况下进行15-20分钟的扫描。 如果双回声化学转移MR成像被证明是一种准确的成像工具，用于鉴定低脂肪含量的肾上腺腺瘤，而无与伦比的CT无法可靠地识别，那么患者将受益于这种成像方法的优势，包括缺乏电离辐射，缺乏肾毒性的风险和肾毒性的风险，并具有静脉内化的静脉内反应。