Pathological manifestation of difference in washout pattern of adrenal hyperplasia on dynamic CT

Akihiro Nishie, Yoshiki Asayama, Kousei Ishigami, Daisuke Kakihara, Tomohiro Nakayama, Yasuhiro Ushijima, Yukihisa Takayama, Akira Yokomizo, Katsunori Tatsugami, Junichi Inokuchi, Nobuhiro Fujita, Yuichiro Kubo, Shinichi Aishima, Masakazu Hirakawa, Hiroshi Honda

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4 Citations (Scopus)


Introduction: The relationship between the washout pattern and constituent cell in adrenal hyperplasia (AH) has not been fully investigated. The purpose of this study was to elucidate the radiological or pathological factors determining the washout pattern of AH on dynamic CT. Methods: Ten patients with 14 surgically proven AHs were enrolled. Dynamic CT was scanned before (pre-contrast image) and 60 seconds (early phase) and 240 seconds (delayed phase) after administration of iodine contrast. The absolute percentage washout (APW) of each nodular lesion was calculated using the following formula: APW(%) = (TAearly-TAdelay)/(TAearly- TApre) x 100, when TApre, TAearly and TAdelay were defined as tumour attenuation values of pre-contrast, early and delayed phases, respectively. Pathologically, the clear cell ratio (CCR) constituting each nodular lesion was qualitatively assessed. Regression analysis was performed to evaluate a correlation between each pair of CCR, TApre, (TAearly-TAdelay) and APW. Results: There was a significant correlation between each pair of CCR, TApre and APW. CCR decreased as TApre increased (r = 0.81, P < 0.001). APW increased as CCR decreased (r = 0.80, P < 0.001) or as TApre increased (r = 0.74, P < 0.01). Conclusions: The key factors of washout pattern of AH on dynamic CT were CCR and TApre. The difference in constituent cell was associated with variability in APW of AH.

Original languageEnglish
Pages (from-to)559-564
Number of pages6
JournalJournal of Medical Imaging and Radiation Oncology
Issue number5
Publication statusPublished - Oct 1 2014

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging


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