{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:34:17Z","timestamp":1780468457208,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T00:00:00Z","timestamp":1522972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>To investigate whether any association between chemical shift magnetic resonance (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) findings, cortisol secretion and pathological findings exists that could predict subclinical hypercortisolism (<jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content>) in patients with adrenal incidentalomas (<jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective, cross\u2010sectional study in a tertiary centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Sixty\u2010eight subjects with <jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content>s and 13 patients with Cushing's syndrome (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>). Patients with <jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content>s were categorized according to cortisol levels post 1\u00a0mg dexamethasone (post\u2010<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Visual inspection of the lipid content of the adrenal tumour and calculation of adrenal\u2010to\u2010spleen ratio (<jats:styled-content style=\"fixed-case\">ASR<\/jats:styled-content>), the signal intensity index (<jats:styled-content style=\"fixed-case\">SII<\/jats:styled-content>), volume and the assessment of the association between pathological, radiological and hormonal findings in surgically treated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Percentage of clear cells was correlated with <jats:styled-content style=\"fixed-case\">ASR<\/jats:styled-content> (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u2212.525, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01), <jats:styled-content style=\"fixed-case\">SII<\/jats:styled-content> (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.465, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.025), post\u2010<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content> cortisol (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u2212.711, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.475, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.046). By <jats:styled-content style=\"fixed-case\">ANOVA<\/jats:styled-content> and post hoc analysis, patients with <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> and five subjects with a post\u2010<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content> cortisol greater than 137\u00a0nmol\/L differed significantly in <jats:styled-content style=\"fixed-case\">ASR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SII<\/jats:styled-content> from those with a post\u2010<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content> cortisol less than 50\u00a0nmol\/L. An <jats:styled-content style=\"fixed-case\">ASR<\/jats:styled-content> level higher than 0.245 (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 19.7, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.5\u2010257.5; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.023) and a <jats:styled-content style=\"fixed-case\">SII<\/jats:styled-content> level lower than 78.37 (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 15.6, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.2\u201020; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.034) remained as the independent predictors for <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content> while age, presence of arterial hypertension or tumour volume did not make significant contribution to the models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cortisol hypersecretion by adrenal adenomas is associated with distinctive <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> characteristics. The quantitative assessment of intracellular lipid in an <jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content> could help distinguish patients with a clear phenotype of <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13587","type":"journal-article","created":{"date-parts":[[2018,3,2]],"date-time":"2018-03-02T01:06:38Z","timestamp":1519952798000},"page":"779-786","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Chemical shift magnetic resonance imaging could predict subclinical cortisol production from an incidentally discovered adrenal mass"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0427-735X","authenticated-orcid":false,"given":"Serkan","family":"Yener","sequence":"first","affiliation":[{"name":"Department of Endocrinology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Secil","sequence":"additional","affiliation":[{"name":"Department of Radiology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Urology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9457-8919","authenticated-orcid":false,"given":"Basak","family":"Ozgen Saydam","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Dokuz Eylul University School of Medicine  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kutsal","family":"Yorukoglu","sequence":"additional","affiliation":[{"name":"Department of Pathology Dokuz Eylul University School of Medicine  Izmir 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