Background The majority of Cushing’s syndrome (CS) cases constitute patients with functional adrenal adenomas. In adrenal CS, visceral adipose tissue (VAT) area, VAT/subcutaneous adipose tissue (SAT), and VAT/total adipose tissue (TAT) ratios are expected to decrease in response to adrenalectomy, although no change is expected in non-functioning adrenal adenomas (NFA). Objective To evaluate the changes in VAT, SAT, TAT areas and VAT/SAT, VAT/TAT ratios using computed tomography (CT) in patients who underwent adrenalectomy due to adenomas. Methods Preoperative and postoperative CT of 32 patients (16 with CS and 16 with NFA) were retrospectively evaluated. The VAT, SAT, TAT areas were obtained from CT at the level of L1–2 intervertebral disc space, and the VAT/SAT, VAT/TAT ratios were calculated. The postoperative parameter changes in both groups were evaluated compared to the preoperative values. The level of statistical significance was considered as p<0.05. Results The time interval between preoperative and postoperative CT measurements were 10.37 months (6–17) in CS and 9.75 months (7–15) in NFA groups (p=073). Preoperative CT indicated that the patients with CS had larger VAT and TAT areas (p=0.03, p=0.02) but SAT remained unchanged (p=0.08). However, postoperative CT revealed that there was no difference between the two groups in terms of VAT, TAT, and SAT areas (p=0.87, p=0.36, p=0.14). Postoperatively, in patients with CS, there was a decrease in VAT and TAT areas (p=0.01 for both) and VAT/SAT and VAT/TAT ratios (p=0.03, p=0.02) but SAT remained unchanged (p=0.10). In patients with NFA, no change was detected in the postoperative SAT, TAT, and VAT areas (p=0.12, p=0.40, p=0.99) or the VAT/SAT and VAT/TAT ratios (p=0.38, p=0.62). Conclusions Adrenalectomy is an effective treatment method leading to a decrease in the VAT, TAT areas, and VAT/SAT and VAT/TAT ratios in patients with cortisol producing adrenocortical adenoma. Thus, CT facilitates quantitative demonstration of the changes while evaluating the response of these patients to treatment.

中文翻译：

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因库欣综合征和无功能腺瘤而接受肾上腺切除术的患者基于 CT 的腹部脂肪组织面积变化

背景 大多数库欣综合征 (CS) 病例构成功能性肾上腺腺瘤患者。在肾上腺 CS 中，内脏脂肪组织 (VAT) 区域、VAT/皮下脂肪组织 (SAT) 和 VAT/总脂肪组织 (TAT) 比率预计会随着肾上腺切除术而降低，尽管预计无功能肾上腺不会发生变化腺瘤（NFA）。目的利用计算机断层扫描（CT）评估因腺瘤行肾上腺切除术的患者VAT、SAT、TAT面积和VAT/SAT、VAT/TAT比值的变化。方法回顾性评价32例患者（CS 16例，NFA 16例）的术前、术后CT表现。从 L1-2 椎间盘间隙水平的 CT 获得 VAT、SAT、TAT 区域，并计算 VAT/SAT、VAT/TAT 比率。将两组术后参数变化与术前值进行比较。统计学显着性水平被认为是p<0.05。结果 CS 组术前和术后 CT 测量的时间间隔为 10.37 个月 (6-17)，NFA 组为 9.75 个月 (7-15) (p=073)。术前 CT 显示 CS 患者的 VAT 和 TAT 面积较大（p=0.03，p=0.02），但 SAT 保持不变（p=0.08）。然而，术后 CT 显示，两组在 VAT、TAT 和 SAT 区域方面没有差异（p=0.87，p=0.36，p=0.14）。术后，在 CS 患者中，VAT 和 TAT 面积（两者均 p=0.01）以及 VAT/SAT 和 VAT/TAT 比率（p=0.03，p=0.02）减少，但 SAT 保持不变（p=0.10） . 在 NFA 患者中，术后 SAT、TAT 和 VAT 区域（p=0.12，p=0.40，p=0.99）或 VAT/SAT 和 VAT/TAT 比率（p=0.38，p=0.62）未检测到变化。结论 肾上腺切除术是一种有效的治疗方法，可降低产生皮质醇的肾上腺皮质腺瘤患者的 VAT、TAT 面积、VAT/SAT 和 VAT/TAT 比值。因此，CT 有助于在评估这些患者对治疗的反应时对变化进行定量证明。