Adrenal tuberculosis: contrast-enhanced CT features with clinical correlation

Objective: To investigate the correlation between specific features on contrast-enhanced CT and its clinical findings of adrenal tuberculosis so as to improve the diagnostic accuracy of the disease. Methods: Contrast-enhanced CT features in 30 patients with documented adrenal tuberculosis were retrospectively evaluated blindly for the features of location, size, morphology, attenuation and enhancement patterns on CT images, and compared with clinical and pathological materials. Results: The common CT manifestations were as follows: enlargement of the adrenal glands in all 30 cases (bilateral 90%, unilateral 10%) including mass-like enlargement in 13 cases and enlargement but the contours preserved in 17 cases, heterogeneity (28 cases, 93.3%), calcification (17 cases, 56.7%), and low attenuation in the center with peripheral enhancement (16 cases, 53.3%) of the lesions. After antitubereulosis chemotherapy, 5 cases of enlarged adrenal glands decreased in size or returned to normal size and configuration, with disappearance of the central low attenuation and new appearance of dot-like calcification in 2 cases. Cochran Armitage trend test showed there was an increasing tendency of calcification rate with clinical duration (χ=27.47, P<0.05), but a decreasing tendency of peripheral enhancement (χ2=6.60, P<0.05). Conclusions: Adrenal tuberculosis has some characteristic manifestations on CT, which had some correlations with its clinical findings and can guide clinical treatment and evaluation. (authors)