FUNCTIONAL/MORPHOLOGIC IMAGING OF THE ADRENAL MASS

本多学科研究有两个主要目的。 1.评价肾上腺组织定征的可能性， 临床无症状肾上腺肿块的患者使用影像学检查， 均具有功能性（6B-131I-碘甲基-19-去甲胆甾-5（10）-EN-3-B-OL [NP-59]肾上腺皮质造影）和形态学（磁共振 成像[MRI]。 2.已知肾上腺功能亢进和肾上腺肿块的患者， 评价MRI的组织定征潜力。 具体目标包括以下方面 目标. 1.优化组织的MR脉冲序列和定量数据 特征化的目的。 2.确定MRI是否可以可靠地区分非功能亢进 肾上腺转移的肾上腺腺瘤。 3.确定MRI是否可以可靠地区分非功能亢进 肾上腺皮质和髓质功能亢进的肾上腺腺瘤 肿瘤。 4.用NP-59脑血管造影描绘异常的脑血管功能 在非肿瘤患者中CT偶然检测到肾上腺， 肿瘤患者。 5.目的：确定NP-59骨显像在评价骨缺损中的准确性。 临床上无症状的肾上腺肿块，特别是在区分 非功能亢进腺瘤转移。 6.将正常与异常的微分功能关联起来 通过定量NP-59肾上腺皮质成像。 7.比较功能（NP-59）和形态（MRI）的有效性 测试评估临床无症状肾上腺肿块。 8.在一小组临床无症状肾上腺肿块的患者中， 比较在高（1.5 - 2.OT）和低（1.5 - 2.OT）下获得的MRI定量数据 （.35T）场强。 总之，基于我们初步调查的假设是： 1. MRI和NP-59脑血管造影将被证明是非常有用的， 肾上腺组织特征和鉴别诊断。 2.这些检查应该可以排除在一部分患者中进行活检的需要 肾上腺肿块

There are 2 major aims for this multidisciplinary investigation. 1. To evaluate the potential for adrenal tissue characterization in patients with clinically silent adrenal masses using imaging tests which are both functional (6B-131I-Iodomethyl-19-Norcholest-5(10)-EN-3-B-OL [NP-59] adrenal cortical scintigraphy) and morphologic (magnetic resonance imaging [MRI]. 2. In patients with known adrenal hyperfunction and an adrenal mass to evaluate the tissue characterization potential of MRI. Encompassed within the scope of the specific aims are the following objectives. 1. To optimize MR pulse sequences and quantitative data for tissue characterization purposes. 2. To determine whether MRI can reliably distinguish nonhyperfunctioning adrenal adenomas from adrenal metastases. 3. To determine whether MRI can reliably distinguish nonhyperfunctioning adrenal adenomas from hyperfunctioning adrenal cortical and medullary neoplasms. 4. To delineate using NP-59 scintigraphy the function of the abnormal adrenal gland incidentally detected by CT in the non-oncologic and oncologic patient. 5. To determine the accuracy of NP-59 scintigraphy in evaluation of the clinically silent adrenal mass, particularly in distinguishing nonhyperfunctioning adenoma from metastasis. 6. To correlate the differential function of the normal vs. abnormal adrenal by quantitative NP-59 scintigraphy. 7. To compare efficacy of the functional (NP-59) and morphologic (MRI) tests in evaluating the clinically silent adrenal mass. 8. In a small group of patients with clinically silent adrenal masses to compare quantitative data from MRI obtained at both high (1.5-2.OT) and low (.35T) field strengths. In summary, hypotheses based on our preliminary investigations are: 1. Both MRI and NP-59 scintigraphy will prove to be extremely useful in adrenal tissue characterization and differential diagnosis. 2. These tests should obviate the need for biopsy in a subset of patients with adrenal masses.