中国医学装备2026，Vol.23Issue(1)：45-49,5.DOI:10.3969/j.issn.1672-8270.2026.01.008
螺旋CT多期增强成像联合昼夜血清皮质醇节律检测对肾上腺意外瘤功能评估的协同效应研究
Synergistic effect of spiral CT multiphase contrast-enhanced imaging combined with circadian test for serum cortisol in evaluating function of adrenal incidentaloma
摘要
Abstract
Objective:To explore synergistic diagnostic value of multiphase contrast-enhanced spiral computed tomography(CT)combined with circadian test for serum cortisol on functional subtyping of adrenal incidentalomas.Methods:A total of 123 patients with adrenal incidentalomas who were confirmed at Peking University Third Hospital Qinhuangdao Hospital between January 2023 and January 2025 were enrolled.Based on the results of functional assessment,patients were divided into a functional adenoma group(n=56)and a non-functional adenoma group(n=67).The differences of CT values of plain scan,enhancement value of arterial phase,imaging features of absolute clearance rate of venous phase,as well as endocrine markers such as cortisol rhythm,renin-angiotensin Ⅱ-aldosterone levels,aldosterone-to-renin ratio(ARR),and catecholamine metabolites were compared between the two groups.A logistic regression model was constructed to assess the diagnostic performance of spiral CT multiphase contrast-enhanced imaging combined with circadian test for serum cortisol.Results:The CT value[(32.7±8.5)HU]of plain scan,enhancement value[(68.3±15.2)HU]of arterial phase,and absolute clearance rate(42.1±9.8)%of venous phase of functional adenoma group were significantly higher than those[(18.4±6.2)HU,(45.6±12.8)HU and(28.5±7.3)%]of non-functional adenoma group,and the differences were significant(t=5.781,8.342,7.910,P<0.05).The diagnostic sensitivity and area under curve(AUC)value of receiver operating characteristic(ROC)curve of spiral CT multiphase contrast-enhanced imaging combined with circadian test for serum cortisol were respectively 96.4%and 0.916.Multivariate analysis identified the CT value of plain scan was>24 HU,abnormal circadian of serum cortisol,and ARR>30 were respectively independent predictor of functional subtype(OR=6.234,8.912,12.671,P<0.05).Conclusion:The combined application of spiral CT quantitative parameters,and dynamic endocrine characteristics of cortisol can significantly improve the accuracy of functional assessment in adrenal incidentalomas,which can provide non-invasively diagnostic basis for conducting stratification management of clinical disease.关键词
肾上腺意外瘤/螺旋CT/皮质醇节律/醛固酮-肾素活性比值/协同效应Key words
Adrenal incidentaloma/Spiral computed tomography(CT)/Cortisol circadian/Aldosterone-to-renin ratio(ARR)/Synergistic effect分类
医药卫生引用本文复制引用
杜维冠,吉晓曦,胡树凤,朱国栋,张杨,王平安..螺旋CT多期增强成像联合昼夜血清皮质醇节律检测对肾上腺意外瘤功能评估的协同效应研究[J].中国医学装备,2026,23(1):45-49,5.基金项目
河北省2020年度医学科学研究计划(20201313) （20201313）
秦皇岛市市级科技计划资助项目(202301A175) Qinhuangdao S&T Plan Program(202301A175) （202301A175）
Medical Science Research Plan of Hebei Province in 2020(20201313) （20201313）
