Objective
Mild autonomous cortisol secretion (MACS) has been associated with a higher prevalence of osteoporosis, although most data rely on single-center studies with limited sample size. We aimed to assess the prevalence of fragility fractures and contributing factors in a large cohort of patients with adrenal incidentalomas.
Design and Methods
Medical records of 1023 patients with adrenal incidentalomas from 1990 to 2019 were reviewed, and 735 patients were selected. Clinically-obtained electronic radiological images closest to first endocrine evaluation, such as lateral views of spine X-rays or CT thoraco-abdominal scans, were reviewed to screen for asymptomatic morphometric vertebral fractures. Clinical fragility fractures, hormonal and DXA indices were also recorded.
Results
474 patients had non-functioning (NF) adrenal incidentalomas, 238 had MACS and 23 Adrenal Cushing’s Syndrome (AC). Prevalence of fragility fractures was different (P = 0.018) between groups, respectively 24.1% (NF), 34.0% (MACS) and 30.4% (AC), with significant difference between NF and MACS (P = 0.012). When analyzed separately by sex and menopausal status, this difference remained significant in post-menopausal women (P = 0.011), with a fracture prevalence of 22.2% (NF), 34.6% (MACS). Fracture prevalence was similar in males. Women with MACS aged ≥65 years reported a 48.8% prevalence of fractures, as compared with 29.5% in NF (P < 0.01). In post-menopausal women, fragility fractures were associated with age (OR 1.1, P < 0.001), smoking (OR 1.8, P = 0.048) and 1mg-DST cortisol (OR 3.1, P = 0.029), while in men, only age was associated with fragility fractures.
Conclusions
A considerable fracture burden was shown in post-menopausal women with adrenal incidentalomas and MACS, with clinical implications for the evaluation and management of bone metabolism.
During the coronavirus disease 19 (COVID-19) pandemic, extracorporeal membrane oxygenation (ECMO) has been proposed as a possible therapy for COVID-19 patients with acute respiratory distress syndrome. This pictorial review is intended to provide radiologists with up-to-date information regarding different types of ECMO devices, correct placement of ECMO cannulae, and imaging features of potential complications and disease evolution in COVID-19 patients treated with ECMO, which is essential for a correct interpretation of diagnostic imaging, so as to guide proper patient management.
Aims:
Texture analysis (TA) is becoming an increasingly used tool in radiological research. Some papers have been published on its use in ultrasound (US), but the way in which the machine settings affect the features has not yet been fully explored. With this research, we analyze how the time gain compensation (TGC) influences the features of the gray-level matrices in the abdominal US setting.
Subjects and Methods:
We analyzed the images acquired from the hepatorenal acoustic window of a healthy 29-year-old volunteer acquired with different TGC settings. TA was carried out using the LifeX software.
Results:
Several both 1
st
and 2
nd
order gray-level matrices features showed a strong correlation with TGC settings.
Conclusions:
TGC settings must be accounted for when carrying out further TA studies.
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