{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:45:49Z","timestamp":1790696749800,"version":"4.1.0"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","issue":"2","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiol Bras"],"abstract":"<jats:p>Abstract  Objective: To investigate the advantages of using modified signal intensity measurements on chemical shift imaging alone or in conjunction with proton magnetic resonance spectroscopy in the differential diagnosis of adrenal adenomas.  Materials and Methods: This was a prospective study involving 97 patients with adrenal nodules or masses. The signal intensity index (SII) was calculated as [(signal intensity on the in-phase image \u2212 signal intensity on the out-of-phase image) \u2215 (signal intensity on the in-phase image)] \u00d7 100%. We determined the averages of the minimum, mean, and maximum signal intensity values measured on three consecutive images. When that was not possible (for smaller lesions), we used one or two images. We employed a region of interest that covered one half to two thirds of the mass. All indices were compared with metabolite ratios derived from spectroscopy: lactate\/creatine; glutamine-glutamate\/creatine; choline\/creatine; choline\/lipid; 4.0-4.3 ppm\/Cr; and lipid\/creatine.  Results: Of the 97 patients evaluated, 69 were diagnosed with adenomas and 28 were diagnosed with nonadenomas. All SII measurements and spectroscopy-derived metabolite ratios were significant to the differentiation between adenomas and nonadenomas, except for the lipid\/creatine and choline\/lipid ratios. In 37.8% of the cases, it was not possible to perform spectroscopy. When it was possible, the lactate\/creatine ratio was found to have higher accuracy than did the SII.  Conclusion: Determining the SII and metabolite ratios increased the accuracy of the differential diagnosis of adrenal adenomas.<\/jats:p>","DOI":"10.1590\/0100-3984.2019.0095","type":"journal-article","created":{"date-parts":[[2020,4,17]],"date-time":"2020-04-17T19:14:43Z","timestamp":1587150883000},"page":"86-94","source":"Crossref","is-referenced-by-count":8,"title":["The value of signal intensity on T1-weighted chemical shift magnetic resonance imaging combined with proton magnetic resonance spectroscopy for the diagnosis of adrenal adenomas"],"prefix":"10.1590","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9865-9537","authenticated-orcid":false,"given":"Claudio Carvalho","family":"Dalavia","sequence":"first","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3596-3419","authenticated-orcid":false,"given":"Suzan Menasce","family":"Goldman","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5287-9294","authenticated-orcid":false,"given":"Homero Jos\u00e9 de Farias e","family":"Melo","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4350-1070","authenticated-orcid":false,"given":"Claudio Elias","family":"Kater","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-0529","authenticated-orcid":false,"given":"Jacob","family":"Szejnfeld","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6426-5636","authenticated-orcid":false,"given":"Wagner","family":"Iared","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6033-6583","authenticated-orcid":false,"given":"Sergio Aron","family":"Ajzen","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2020,4]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1148\/radiol.2313030676","article-title":"Chemical shift MR imaging of hyperattenuating (&gt;10 HU) adrenal masses: does it still have a role?","volume":"231","author":"Haider 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