The Lateralizing Asymmetry of Adrenal Adenomas.
The Lateralizing Asymmetry of Adrenal Adenomas.
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DOI：
10.1210/js.2018-00034
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发表时间：
2018-04-01
影响因子：
4.1
通讯作者：
Vaidya A
中科院分区：
文献类型：
--
作者：
Hao M;Lopez D;Luque-Fernandez MA;Cote K;Newfield J;Connors M;Vaidya A
据推测，肾上腺腺瘤的发病率在左右肾上腺之间是对称的；然而，轶事观察表明存在潜在的侧化不对称性。研究肾上腺腺瘤检测的对称性及其与患者护理的相关性。横断面和纵向研究。 1376 名患者的腹部计算机断层扫描或磁共振成像显示出良性的肾上腺腺瘤。肾上腺腺瘤的位置和大小。 65% 的患者发现左侧腺瘤，21% 发现右侧腺瘤，14% 发现双侧腺瘤。在单侧腺瘤中，75% 为左侧。在每个尺寸类别中，左侧腺瘤比右侧腺瘤更常见，最大的除外：<10 毫米，87%； 10至19毫米，74%； 20至29毫米，72%； ≥30 mm，56%（每个类别 P < 0.0001，≥30 mm 时 P = 0.19 除外）。在双侧腺瘤患者中，61% 的患者左侧腺瘤明显大于右侧腺瘤 (P < 0.001)。在 5.10 (4.2) 年的随访期间，左侧与右侧腺瘤患者的心脏代谢疾病基线患病率或发生率没有显着差异。左侧肾上腺比右侧更容易发现肾上腺腺瘤。这一观察结果可能是由于右肾上腺位置造成的检测偏差，这可能会妨碍右侧腺瘤的识别，直到它们明显变大。这些发现表明，右侧腺瘤的识别可能不够，这也可能损害双侧肾上腺疾病的准确检测。左侧肾上腺腺瘤比右侧肾上腺更容易被检测到，这凸显了检测右侧腺瘤和双侧肾上腺疾病的准确性可能受损。
It is presumed that the incidence of adrenal adenomas is symmetric between the left and right adrenal gland; however, anecdotal observations suggest a potential lateralizing asymmetry. To investigate the symmetry in detection of adrenal adenomas and relevance to patient care. Cross-sectional and longitudinal studies. One thousand three hundred seventy-six patients with abdominal computed tomography or magnetic resonance imaging demonstrating benign-appearing adrenal adenomas. Location and size of adrenal adenomas. Left-sided adenomas were discovered in 65% of patients, right-sided in 21%, and bilateral adenomas in 14%. Among unilateral adenomas, 75% were left-sided. Left-sided adenomas were more prevalent than right-sided adenomas in each size category except the largest: <10 mm, 87%; 10 to 19 mm, 74%; 20 to 29 mm, 72%; ≥30 mm, 56% (P < 0.0001 for each category, except P = 0.19 when ≥30 mm). Among those with bilateral adenomas, the left-sided adenoma was significantly larger than the right one in 61% of patients (P < 0.001). There were no significant differences in the baseline prevalence or incidence of cardiometabolic diseases between patients with left-sided vs right-sided adenomas during 5.10 (4.2) years of follow-up. Adrenal adenomas are substantially more likely to be identified on the left adrenal than the right. This observation may be due to detection bias attributed to the location of the right adrenal, which may preclude identification of right-sided adenomas until they are substantially larger. These findings suggest the potential for an underrecognition of right-sided adenomas that may also impair the accurate detection of bilateral adrenal diseases. Adrenal adenomas are more likely to be detected on the left than the right adrenal, highlighting a potential impaired accuracy in detecting right-sided adenomas and bilateral adrenal diseases.