Contrast-enhanced computed tomography as a preoperative indicator of vascular invasion from adrenal masses in dogs.

Abstract

The purpose of this study was to determine if contrast-enhanced computed tomography (CT) accurately reflected vascular luminal invasion by adrenal masses in dogs. Medical records of 15 dogs with 17 adrenal masses that underwent preoperative CT imaging were reviewed. Presence or absence of vascular invasion was confirmed by surgery or necropsy/histology. Vascular invasion was identified correctly using contrast-enhanced CT in 11/12 dogs. The sensitivity and specificity of contrast-enhanced CT for vascular invasion compared with surgery or necropsy was 92% and 100%, respectively. The positive predictive value and negative predictive value of contrast-enhanced CT was 100% and 90%, respectively. The accuracy was 95%. In one dog, invasion of the phrenicoabdominal vein was not identified on CT images. Six of eight masses with vascular invasion where a histologic diagnosis was obtained were malignant. Four of four pheochromocytomas invaded adjacent vasculature. Contrast-enhanced CT provided accurate preoperative assessment of adrenal masses. Vascular invasion by adrenal masses in this study occurred by way of the lumen of the phrenicoabdominal vein with subsequent intraluminal extension into other veins, rather than by erosion through vessel walls.