THE INFORMATIVE VALUE OF VARIOUS DIAGNOST IC METHODS IN ITSENKO - CUSHINGS-DISEASE

The authors studied the informative value of various diagnostic method s: ultrasonic examination (USE), computed tomography (CT), magneto-res onance tomography (MRT), phlebography with separate collection of bloo d from the inferior vena cava and its hormonal investigation in Itsenk o - Cushing's disease (52 cases). All patient underwent operation, and because of this the changes detected in the adrenals by various diagn ostic methods of examination were compared with the morphological find ings. Three patients were subjected to bilateral adrenalectomy. Morpho logical study of the adrenals revealed diffuse hyperplasia of the cort ex in 17 cases, macro- and microadenomas in hyperplasia of the adrenal s in 23, and diffuse-nodular hyperplasia in 15 cases. In macroadenomat osis identification, the informative value of MRT was 77.8 %, CT 66.6 %, and USE 22.2 %. MRT was most informative in detection of microedeno matosis and diffuse-nodular hyperplasia -82.3 % of cases; the respecti ve values for CT and USE were 71.4 % and 56.5 %. The quantitative para meters of the adrenal tissue were studied in MRT: relaxation time (T-2 ) and the value of relative signal intensity (E). The value of relativ e signal intensity was lower in micro-macroadenomatosis than in diffus e and diffuse-nodular hyperplasia. The use of the quantitative paramet ers (T-2 and E) increases the diagnostic possibilities of MRT and prov ides for a more authentic idea of the character of the pathological ch anges in the adrenal tissue. Precise verification of the pathological process in the adrenal cortex allows the optimal treatment to be chose n, adrenalectomy to be considered in time, and the side of the operati on to be correctly determined.