Differentiation between small benign and malignant adrenal masses with dynamic incremented CT

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Abstract
Contrast-enhanced dynamic incremented CT scans in 37 patients with 44 small adrenal masses (28 benign and 16 malignant) were reviewed by two observers unaware of the histologic diagnosis to determine if applying morphologic criteria could help differentiate small benign adrenal masses from malignant adrenal masses. Only lesions smaller than 5 cm with diagnoses confirmed by histology (12 masses) or follow-up (32 masses) were included. Features evaluated to suggest a benign diagnosis were homogeneous low attenuation, possibly with punctate contrast enhancement; an enlarged gland (adrenal configuration maintained); a thin or absent rim; round or oval shape with sharp margins; and diffusely homogeneous attenuation about equal to or greater than that of muscle. Features studied to suggest a malignant diagnosis were a thick enhancing rim, invasion of adjacent structures, irregular or poorly defined margins, and inhomogeneous attenuation. Both observers' diagnoses of benign vs malignant lesions with CT criteria ...

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