Adrenal adenomas and nonadenomas: the preliminary study of correlation between appearances of dynamic contrast-enhanced CT and tumoral angiogenesis

Abstract

Objective To analyze the correlation between the typical findings of dynamic contrast-enhanced CT (DCT) and tumoral angiogenesis[microvessel density, MVD and vascular endothelial growth factor, VEGF] of adenoma and nonadenoma and elucidate the mechanism of enhancement on DCT.Methods Forty-two cases with 46 adrenal masses proven surgically and pathologically were included in the study, which was composed of 23 adenomas, 18 nonadenomas and 5 hyperplastic nodules. DCT and angiogenesis were studied in all adrenal masses. Appearances of DCT of adenoma and nonadenoma were first evaluated, and then, to further explore whether enhanced characteristics of DCT of adrenal masses were closely correlated with tumoral angiogenesis. Results Adrenal adenoma was significantly different from nonadenoma in T-D curve, 7min-delayed Washr and Washa of DCT. The mean MVD and VEGF expression had significant difference between Group faster Wash(type A,C) and Group slower Wash(type B,D,E), 7min-delayed Washr≥34% and Washa≥43%, and 7min-delayed Washr≥34% and Washa≥43%(P=0.000). Adenomas were suggested when adrenal masses presented as Type A and C, and/or Washr≥34%,and/or Washa≥43%, vice versa, nonadenoma. These findings showed close correlation of both enhancement appearances of DCT and MVD and VEGF expression of adrenal masses. On the other hand, there was significant difference in MVD and VEGF expression between adenoma and nonadenoma. Conclusion MVD and VEGF were the main pathological factors of DCT of adrenal masses, which resulted in different T-D curve, Washr and Washa of adrenal DCT.