Add comprehensive documentation for adrenal conditions
- Created detailed articles for Adrenal Adenoma, Adrenal Cyst, Adrenal Myelolipoma, and general Adrenal anatomy. - Included key facts, imaging findings, differential diagnoses, pathology, clinical issues, and diagnostic checklists for each condition. - Enhanced understanding of adrenal tumors and their characteristics through structured documentation.
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"efec45ee8dc4278fbe64ab80f93dcc4fe377fe844171367e892969cf9946232d": "docs_md/external/https-appstatdxcom-tree-genitourinary-bd0eb4fe-d465-4faa-a3b7-526e8f01802d_app.statdx.com_tree_genitourinary_bd0eb4fe-d465-4faa-a3b7-526e8f01802d_13437510_20251017T212316Z.meta.md"
|
||||
}
|
||||
@@ -0,0 +1,334 @@
|
||||
---
|
||||
title: "Adrenal Adenoma"
|
||||
docid: "e2916d86-5f9f-4dd3-9576-1a7b89d8dda0"
|
||||
breadcrumbs:
|
||||
- "Genitourinary"
|
||||
- "Diagnosis"
|
||||
- "Adrenal"
|
||||
- "Benign Neoplasms"
|
||||
- "Adrenal Adenoma"
|
||||
---
|
||||
# KEY FACTS
|
||||
|
||||
- ## Imaging
|
||||
|
||||
|
||||
- Well-circumscribed, uniform, low-attenuation, small adrenal mass
|
||||
- Low attenuation due to abundant intracytoplasmic lipid
|
||||
- Imaging features of typical lipid-rich adenomas
|
||||
- NECT: < 10 HU (71% sensitivity, 98% specificity)
|
||||
- MR: Significant decrease in signal on out-of-phase T1WI due to intravoxel lipid and water
|
||||
- May show focal areas of heterogeneous attenuation or absence of signal loss due to degeneration, hemorrhage, and fibrin deposition
|
||||
- Clinical context key to differentiate from collision tumor: Unlikely in absence of extraadrenal malignancy
|
||||
- Lipid-poor adenomas (10-40% cases): Utilize relative or absolute CT contrast washout kinetics for diagnosis
|
||||
- Accounts for vast majority of adrenal "incidentalomas"
|
||||
- Imaging intensive algorithm suggested for incidental adrenal lesions, though overwhelming majority are benign and hormonally inactive
|
||||
- Primary hyperaldosteronism (Conn syndrome): 80% due to unilateral, typically small (< 2 cm) adenoma
|
||||
- Cushing syndrome: 80-85% due to adrenal hyperplasia
|
||||
- Typically shows FDG uptake < that of liver on PET/CT
|
||||
- ## Top Differential Diagnoses
|
||||
|
||||
|
||||
- Adrenal metastases and lymphoma
|
||||
- Adrenal (macronodular) hyperplasia
|
||||
- Pheochromocytoma
|
||||
- Adrenal carcinoma
|
||||
- Adrenal myelolipoma
|
||||
- Gastric diverticulum
|
||||
- Adrenal cyst
|
||||
- ## Diagnostic Checklist
|
||||
|
||||
|
||||
- Asymptomatic mass: Usually nonfunctioning adenoma, even in patients with known cancer
|
||||
- NECT and MR are equally accurate for diagnosis of lipid-rich adenoma
|
||||
- Utilize dedicated CECT adrenal protocol with 15-minute delayed imaging for diagnosis of potential lipid-poor adenomas
|
||||
|
||||
# TERMINOLOGY
|
||||
|
||||
- ## Definitions
|
||||
|
||||
|
||||
- Benign adrenal cortical tumor
|
||||
|
||||
# IMAGING
|
||||
|
||||
- ## General Features
|
||||
|
||||
|
||||
- ### Best diagnostic clue
|
||||
|
||||
|
||||
- Imaging strategies target typical adenoma histology: Abundant intracytoplasmic lipid
|
||||
- Low attenuation (< 10 HU) on NECT
|
||||
- Significant loss of signal on out-of-phase T1WI MR (intravoxel fat and water)
|
||||
- ### Size
|
||||
|
||||
|
||||
- Cushing syndrome adenoma: 2-5 cm
|
||||
- Conn syndrome adenoma: Classically < 2 cm (20% < 1 cm)
|
||||
- Vast majority of incidental, hormonally inactive adrenal adenomas are small (< 2 cm)
|
||||
- ### Morphology
|
||||
|
||||
|
||||
- Usually round to oval suprarenal mass
|
||||
- Key concepts
|
||||
- Most common adrenal cortex tumor (10% bilateral)
|
||||
- Accounts for > 90% of all "incidentalomas"
|
||||
- May occur in up to 9% of general population, diagnosed on 5% of CT exams with various indications
|
||||
- Lipid-rich adrenal adenoma: 60-90% of adenomas
|
||||
- Lipid-poor adrenal adenoma: 10-40% of adenomas
|
||||
- Increased incidence in patients with diabetes and hypertension
|
||||
- NECT (or chemical shift MR): Study of choice to diagnose incidental adrenal masses
|
||||
- Classified into 2 types based on function
|
||||
- Nonhyperfunctioning: Normal hormone levels
|
||||
- Hyperfunctioning: Primary hyperaldosteronism, Cushing syndrome, hyperandrogenism
|
||||
- **Cushing syndrome**
|
||||
- 15-25% of cases are due to autonomous adrenal adenoma
|
||||
- 80-85% of cases are due to**adrenal hyperplasia**
|
||||
- Adenomas usually > 2 cm
|
||||
- **Primary hyperaldosteronism (Conn syndrome)**
|
||||
- 80% of cases are due to****adrenal adenoma
|
||||
- 20% of cases are due to adrenal hyperplasia
|
||||
- Adenomas are often small (< 2 cm)
|
||||
- ## CT Findings
|
||||
|
||||
|
||||
- ### NECT
|
||||
|
||||
|
||||
- Smooth, well defined, round or oval in shape
|
||||
- Homogeneous soft tissue mass of 0-20 HU
|
||||
- **Lipid-rich adrenal adenoma** (60-90% of cases)
|
||||
- Uniform low attenuation
|
||||
- Metaanalysis of < 10 HU threshold: 71% sensitivity, 98% specificity
|
||||
- Sensitivity may increase to almost 90% with histogram analysis (identify negative pixels), though variable results and scanner dependent
|
||||
- **Lipid-poor adrenal adenoma** (10-40% of cases)
|
||||
- Attenuation varies from 10-30 HU
|
||||
- Difficult to differentiate from metastases on NECT
|
||||
- Cushing syndrome due to adrenal adenoma
|
||||
- Remainder of ipsilateral gland and contralateral adrenal gland may be atrophic due to ↓ ACTH levels
|
||||
- ↑ cortisol: Feedback inhibition on pituitary ACTH
|
||||
- ACTH-independent macronodular hyperplasia: Multiple, bilateral, functioning adrenal adenomas
|
||||
- Conn syndrome due to adrenal adenoma
|
||||
- Remainder of ipsilateral gland and contralateral adrenal gland appear normal
|
||||
- Large adenomas
|
||||
- More heterogeneous than small adenomas
|
||||
- ± hemorrhage, cystic degeneration, calcification
|
||||
- Growth should raise suspicion for malignancy
|
||||
- ### CECT
|
||||
|
||||
|
||||
- Enhancing adrenal mass that deenhances rapidly
|
||||
- Dedicated adrenal CT exam incorporates initial dynamic enhanced phase (~ 70-second delay) and 15-minute delay
|
||||
- Relative percentage washout = dynamic enhanced (HU) - delayed (HU) / dynamic enhanced HU
|
||||
- Relative percentage washout > 40%: 96% sensitivity, 100% specificity
|
||||
- Absolute percentage washout (if NECT available) = dynamic enhanced (HU) - delayed (HU) / dynamic enhanced (HU) - unenhanced (HU)
|
||||
- Absolute percentage washout > 60%: 86-88% sensitivity, 92-96% specificity
|
||||
- 10-minute delay utilized by some centers, but shorter delay may decrease sensitivity
|
||||
- Adrenal washout calculators readily available online
|
||||
- Utilize technique for indeterminate, potentially lipid-poor adenomas
|
||||
- Clinical context critical: Rapid washout can be seen with pheochromocytomas, renal cell, hepatocellular carcinoma, and hypervascular metastases
|
||||
- Dual-energy CT and iodine subtraction techniques can generate virtual noncontrast (VNC) images
|
||||
- May identify lipid-rich adenomas and obviate need for additional imaging
|
||||
- Iodine:VNC ratio ≥ 6.7 has sensitivity and specificity of 95% for adenoma (higher ratios in adenoma compared to metastasis)
|
||||
- ## MR Findings
|
||||
|
||||
|
||||
- T1WI and T2WI
|
||||
- Low to intermediate signal
|
||||
- Chemical shift (in- and out-of-phase) imaging
|
||||
- Mainstay of MR diagnosis
|
||||
- Sensitivity and specificity equivalent to NECT
|
||||
- Signal loss on out-of-phase T1WI due to intravoxel water and fat protons
|
||||
- Inverse relationship between percentage of lipid-rich cells and relative ↓ signal on out-of-phase imaging
|
||||
- May not identify lipid-poor adenomas
|
||||
- Visual inspection of signal in phase (SIP) and out of phase (SOP), though quantitative analysis may be helpful
|
||||
- Adrenal to spleen chemical shift imaging (CSI) ratio: Lesion:spleen SOP/adrenal/spleen SIP
|
||||
- < .71 = adenoma
|
||||
- Adrenal signal intensity index: 100 x (SIP - SOP) / SIP
|
||||
- > 16.5% = adenoma
|
||||
- Beware technical pitfalls
|
||||
- Sampling of 1st echo pair at 3T is challenging
|
||||
- India ink artifact mimics signal loss, particularly in small adrenal lesions
|
||||
- Other primary or secondary adrenal lesions may contain lipid
|
||||
- Adenomas and metastases may coexist in same gland (collision tumor)
|
||||
- T1 C+ MR
|
||||
- Rapid, uniform enhancement and deenhancement
|
||||
- Ancillary MR techniques
|
||||
- Diffusion MR: Not specific (ADC overlap between adenomas and metastases)
|
||||
- MR spectroscopy: Choline:creatinine and choline:lipid ratio discriminatory threshold ratios may aid in adrenal lesion characterization, though larger studies needed
|
||||
- ## Ultrasonographic Findings
|
||||
|
||||
|
||||
- ### Grayscale ultrasound
|
||||
|
||||
|
||||
- Nonspecific, solid suprarenal mass
|
||||
- Right suprarenal mass seen more clearly left due to acoustic window provided by liver
|
||||
- ## Angiographic Findings
|
||||
|
||||
|
||||
- Conventional
|
||||
- Adrenal arteriography
|
||||
- Catheterization of renal or inferior adrenal arteries shows vascular supply of adrenal tumors
|
||||
- Adenomas are usually hypo- to moderately vascular
|
||||
- No arterial encasement or venous laking or puddling, which are malignant vascular features
|
||||
- Adrenal venography
|
||||
- Most commonly to obtain adrenal vein samples
|
||||
- Advocated for patients with primary hyperaldosteronism triaged to adrenalectomy
|
||||
- Technically difficult study but may confirm laterality of small, aldosterone-secreting adenoma
|
||||
- Technical approach and criteria for positive study varies; ACTH stimulation may increase accuracy
|
||||
- Adrenal adenoma is seen as filling defect within adrenal gland displacing adjacent vessels
|
||||
- Circumferential vein frequently seen around adrenal adenoma
|
||||
- ## Nuclear Medicine Findings
|
||||
|
||||
|
||||
- PET/CT
|
||||
- Utilized as part of malignancy staging
|
||||
- Markedly increased F-18 FDG uptake characteristic of metastases
|
||||
- Adenomas may also accumulate F-18 FDG, typically less intense than liver
|
||||
- Potential false-negatives: Metastases from primary carcinomas that are non-FDG avid (e.g., neuroendocrine tumors)
|
||||
- SUV thresholds published but adenomas typically less intense than liver
|
||||
- Adrenocortical scintigraphy by using NP-59
|
||||
- NP-59 is cholesterol analog that binds to low-density lipoprotein receptors of adrenal cortex
|
||||
- NP-59 used and dexamethasone: Accentuate uptake in non-ACTH-dependent adrenal tissues (adenoma)
|
||||
- Normal NP-59: When both adrenal glands are seen 5 days after injection or thereafter
|
||||
- Adrenal adenoma: Unilateral early adrenal visualization before day 5 after NP-59 injection
|
||||
- Adrenal hyperplasia: Bilateral early adrenal visualization before day 5 after NP-59 injection
|
||||
- ## Imaging Recommendations
|
||||
|
||||
|
||||
- NECT is initial study of choice to confirm diagnosis of lipid-rich adrenal adenoma
|
||||
- ROI should encompass lesion: Attenuation < 10 HU is diagnostic
|
||||
- In- and out-of-phase MR equivalent to NECT for lipid-rich lesions
|
||||
- Signal dropout on out-of-phase T1WI MR: Qualitative assessment typically suffices
|
||||
- CECT, including 15-minute delayed phase, used for potential lipid-poor adenomas: Calculate either relative or absolute washout
|
||||
|
||||
# DIFFERENTIAL DIAGNOSIS
|
||||
|
||||
- [Adrenal Metastases and Lymphoma](/document/adrenal-lymphoma/44639c90-bd04-4e2a-a470-2c28a0e2ff78)
|
||||
- Adrenal metastases
|
||||
- Unilateral or bilateral masses ± central necrosis, hemorrhage
|
||||
- Usually known to have malignancy elsewhere
|
||||
- NECT: Metastases mimic lipid-poor adenoma
|
||||
- CECT: Hypo- or hypervascular and prolonged washout pattern
|
||||
- Adrenal lymphoma
|
||||
- Usually spread to adrenal gland from retroperitoneal tumor
|
||||
- Unilateral or bilateral masses
|
||||
- Unilateral primary lymphoma (non-Hodgkin) can mimic adenoma
|
||||
- Hypovascular; moderate enhancement with contrast
|
||||
- [Adrenal Myelolipoma](/document/adrenal-myelolipoma/5813a554-06a4-4696-af71-7ce50693039d)
|
||||
- Small or large, asymptomatic adrenal mass
|
||||
- Intramural macroscopic fatty elements on imaging
|
||||
- [Adrenal Hyperplasia](/document/adrenal-hyperplasia/90d09395-41d4-49b4-bb1d-4cb00b8bc272)
|
||||
- Adrenal glands are often symmetrically enlarged
|
||||
- Width of adrenal gland limbs > 10 mm (diagnostic)
|
||||
- No discrete mass or nodule seen as rule
|
||||
- Dominant macronodule of macronodular hyperplasia mimics small adrenal adenomas
|
||||
- Cortisol-secreting adenoma: Remainder of ipsilateral and contralateral glands, atrophic (↓ ACTH)
|
||||
- Macronodular hyperplasia: Both glands are enlarged (due to elevated ACTH levels)
|
||||
- No obvious enhancement and washout pattern seen
|
||||
- [Pheochromocytoma](/document/pheochromocytoma/7d3c4062-643c-4030-8783-f85184ad8132)
|
||||
- Tumor > 3 cm in most cases; classically T2 hyperintense
|
||||
- Highly vascular tumor prone to hemorrhage, necrosis
|
||||
- Bilateral adrenal tumors in multiple endocrine neoplasia (MEN) syndromes
|
||||
- [Unilateral Adrenal Hemorrhage](/document/adrenal-hemorrhage/5812e5c4-ca8a-4af5-884b-f75795bcde0f)
|
||||
- Chronic hematoma: Well-defined, round, low-density, mass-like lesion simulating adenoma
|
||||
- [Adrenal Carcinoma](/document/adrenal-cortical-carcinoma/bdc7a08b-a64f-4bd2-9dfc-24331728e85e)
|
||||
- Rare, unilateral, invasive and enhancing mass
|
||||
- > 6 cm when initially diagnosed
|
||||
- [Gastric Diverticulum](/document/gastric-diverticulum/eeb101f0-8bdf-4771-b44a-fe6e73b3a463)
|
||||
- Abnormal, rounded soft tissue lesion in left suprarenal area; mimics adrenal mass
|
||||
- Diverticular contents do not enhance, whereas adenomas do
|
||||
- Distend stomach with gas and fluid; scan in prone position to distend diverticulum
|
||||
- [Ganglioneuroma](/document/pheochromocytoma/7d3c4062-643c-4030-8783-f85184ad8132)
|
||||
- Younger patients; mean age: 27 years
|
||||
- Larger mass; average tumor size: 8 cm
|
||||
- ## Adrenal Cyst
|
||||
|
||||
|
||||
- Attenuation similar to lipid-rich adenoma
|
||||
- Lack of enhancement, rim calcification may suggest diagnosis
|
||||
|
||||
# PATHOLOGY
|
||||
|
||||
- ## General Features
|
||||
|
||||
|
||||
- ### Etiology
|
||||
|
||||
|
||||
- Unknown
|
||||
- ### Associated abnormalities
|
||||
|
||||
|
||||
- MEN syndromes
|
||||
- Most adrenals with adenoma have normal function
|
||||
- Occasionally adenoma causes adrenal hyperfunction
|
||||
- Normal adrenocortical secretory hormones
|
||||
- Cortisol, aldosterone, androgens
|
||||
- ## Gross Pathologic & Surgical Features
|
||||
|
||||
|
||||
- Well-delineated, tan-yellow, ovoid mass
|
||||
- 3 microscopic patterns
|
||||
- Pure (fasciculata- or reticularis-type cells), mixed, or hybrid
|
||||
- May have focal areas of degeneration, hemorrhage, and fibrin deposition
|
||||
- ## Microscopic Features
|
||||
|
||||
|
||||
- 70% of adenomas: High % of intracytoplasmic lipid
|
||||
- 30% of adenomas: Low % of intracytoplasmic lipid
|
||||
|
||||
# CLINICAL ISSUES
|
||||
|
||||
- ## Presentation
|
||||
|
||||
|
||||
- ### Most common signs/symptoms
|
||||
|
||||
|
||||
- Asymptomatic incidental CT finding
|
||||
- Conn syndrome: Hypertension and weakness
|
||||
- Cushing syndrome: Moon facies, truncal obesity, purple striae, and buffalo hump
|
||||
- Virilization in women
|
||||
- Lab data: ↑ aldosterone, cortisol, &/or androgens
|
||||
- Diagnosis: Clinical, biochemical, imaging, histology
|
||||
- ## Demographics
|
||||
|
||||
|
||||
- ### Age
|
||||
|
||||
|
||||
- Prevalence of adenoma increases with age
|
||||
- Peak at 60-69 years, decreasing thereafter
|
||||
- ### Epidemiology
|
||||
|
||||
|
||||
- Most common adrenal tumor of all incidentalomas
|
||||
- ↑ incidence in patients with diabetes or hypertension
|
||||
- Occurs in up to 9% of population (postmortem data)
|
||||
- ## Natural History & Prognosis
|
||||
|
||||
|
||||
- Prognosis: Excellent when incidental and nonhyperfunctioning
|
||||
- ## Treatment
|
||||
|
||||
|
||||
- No treatment when asymptomatic incidental finding
|
||||
- Laparoscopic removal of gland if hyperfunctioning
|
||||
|
||||
# DIAGNOSTIC CHECKLIST
|
||||
|
||||
- ## Consider
|
||||
|
||||
|
||||
- Asymptomatic mass: Usually nonhyperfunctioning adenoma, even in patient with known cancer
|
||||
- ## Image Interpretation Pearls
|
||||
|
||||
|
||||
- Well-defined, low-density (< 10 HU) suprarenal mass
|
||||
- Enhances with washout pattern > 50% within 15 minutes
|
||||
- Out-of-phase T1WI MR: Signal dropout, lipid-rich mass
|
||||
|
||||
adc00b93-b4c7-4e75-91bd-72023f4cd548
|
||||
@@ -0,0 +1,256 @@
|
||||
---
|
||||
title: "Adrenal Cyst"
|
||||
docid: "c5d717a3-3d6e-4e86-9efe-1ad0ec14740f"
|
||||
breadcrumbs:
|
||||
- "Genitourinary"
|
||||
- "Diagnosis"
|
||||
- "Adrenal"
|
||||
- "Benign Neoplasms"
|
||||
- "Adrenal Cyst"
|
||||
---
|
||||
# KEY FACTS
|
||||
|
||||
- ## Imaging
|
||||
|
||||
|
||||
- "Adrenal cyst" is descriptive term, not pathological diagnosis
|
||||
- True adrenal cysts
|
||||
- Majority are endothelial cysts (lymphangiomas)
|
||||
- Epithelial cysts exceedingly rare
|
||||
- Simple, or minimally complex, adrenal cyst, thin rim calcification, no enhancement
|
||||
- Pseudocysts
|
||||
- Prior hemorrhage inferred
|
||||
- Nonenhancing but complex contents and wall calcification
|
||||
- Relevant history (extraadrenal malignancy, rapid growth), biochemical evaluation (cortisol, metanephrines): Consider underlying adrenal neoplasm
|
||||
- Enhancing soft tissue components may suggest adrenal mass hemorrhage and pseudocyst formation
|
||||
- Parasitic (echinococcal) cyst
|
||||
- Rare outside endemic areas
|
||||
- Typically in setting of generalized echinococcus
|
||||
- ## Top Differential Diagnoses
|
||||
|
||||
|
||||
- Adrenal adenoma
|
||||
- CECT: Enhancing mass without visible wall or peripheral calcifications
|
||||
- Gastric diverticulum
|
||||
- Air-, fluid-, or contrast-filled mass with no enhancement of contents
|
||||
- Adrenal myelolipoma
|
||||
- Macroscopic fat
|
||||
- Necrotic adrenal tumor
|
||||
- Complex wall with heterogeneous contents
|
||||
- Retroperitoneal bronchogenic cyst
|
||||
- ## Clinical Issues
|
||||
|
||||
|
||||
- No treatment required usually
|
||||
- Imaging surveillance performed, although intensity and length of follow-up not defined
|
||||
- Biochemical evaluation (cortisol, metanephrines) routinely performed to exclude underlying adrenal neoplasm
|
||||
- Surgical resection for complex cyst with enhancing components, or symptomatic cyst
|
||||
- ## Diagnostic Checklist
|
||||
|
||||
|
||||
- Complicated cyst has high attenuation, thick enhancing wall, &/or septations
|
||||
|
||||
# TERMINOLOGY
|
||||
|
||||
- ## Definitions
|
||||
|
||||
|
||||
- "Adrenal cyst" is descriptive term, not pathological diagnosis
|
||||
- Can mean true cyst, pseudocyst, or cystic mass
|
||||
|
||||
# IMAGING
|
||||
|
||||
- ## General Features
|
||||
|
||||
|
||||
- ### Best diagnostic clue
|
||||
|
||||
|
||||
- Well-defined, nonenhancing, water-density adrenal mass ± calcifications
|
||||
- ### Location
|
||||
|
||||
|
||||
- Suprarenal
|
||||
- Unilateral > bilateral (8-10% of cases)
|
||||
- ### Size
|
||||
|
||||
|
||||
- < 5 cm (50%), up to 20 cm
|
||||
- ## CT Findings
|
||||
|
||||
|
||||
- ### NECT
|
||||
|
||||
|
||||
- Unilocular or multilocular mass
|
||||
- Well-defined, round to oval, homogeneous mass usually with water (0 HU) or near-water density
|
||||
- Higher- or mixed-attenuation mass (hemorrhage, intracystic debris, crystals)
|
||||
- Wall usually very thin
|
||||
- ↑ wall thickness, up to 3 mm for complex cysts
|
||||
- Calcifications
|
||||
- Rim-like or nodular (51-69%)
|
||||
- Centrally in intracystic septation (19%)
|
||||
- Punctate within intracystic hemorrhage (5%)
|
||||
- ### CECT
|
||||
|
||||
|
||||
- No central enhancement ± wall enhancement
|
||||
- Coronal reformats helpful to determine organ of origin if large cyst
|
||||
- ## MR Findings
|
||||
|
||||
|
||||
- ### T1WI
|
||||
|
||||
|
||||
- Homogeneous, hypointense mass
|
||||
- Hyperintense mass (hemorrhage)
|
||||
- ### T2WI
|
||||
|
||||
|
||||
- Hyperintense mass
|
||||
- ## Ultrasonographic Findings
|
||||
|
||||
|
||||
- Simple or septated suprarenal cyst
|
||||
- Shadowing from calcification
|
||||
- Real-time examination helpful to differentiate adrenal cyst from adjacent (renal, pancreatic) cyst
|
||||
- ## Imaging Recommendations
|
||||
|
||||
|
||||
- ### Best imaging tool
|
||||
|
||||
|
||||
- CECT or MR; US for confirmation
|
||||
|
||||
# DIFFERENTIAL DIAGNOSIS
|
||||
|
||||
- [Adrenal Adenoma](/document/adrenal-adenoma/e2916d86-5f9f-4dd3-9576-1a7b89d8dda0)
|
||||
- NECT: Lipid-rich adenoma (< 10 HU) mimics adrenal cyst
|
||||
- Peripheral or septal calcification favors adrenal cyst
|
||||
- CECT: **Enhancing mass** without visible wall or peripheral calcifications
|
||||
- Assess washout kinetics to diagnose lipid-poor adenoma
|
||||
- MR: Signal suppression at out-of-phase, chemical-shift imaging
|
||||
- US: Solid adrenal lesion
|
||||
- [Gastric Diverticulum](/document/gastric-diverticulum/eeb101f0-8bdf-4771-b44a-fe6e73b3a463)
|
||||
- May simulate left adrenal cyst
|
||||
- Air-, fluid-, or contrast-filled suprarenal mass
|
||||
- No enhancement
|
||||
- Normal adjacent adrenal gland
|
||||
- [Adrenal Myelolipoma](/document/adrenal-myelolipoma/5813a554-06a4-4696-af71-7ce50693039d)
|
||||
- Fat (not fluid) attenuation mass
|
||||
- ## Necrotic Adrenal Tumor
|
||||
|
||||
|
||||
- Primary (pheochromocytoma or carcinoma) or metastatic
|
||||
- Clinical history, biochemical evaluation, lesion complexity suggest correct diagnosis
|
||||
- Enhancing soft tissue components
|
||||
- ## Retroperitoneal Bronchogenic Cyst
|
||||
|
||||
|
||||
- Rare, benign, suprarenal fluid or soft tissue attenuation lesion
|
||||
- Adjacent to but separate from adrenal gland
|
||||
- ## Renal Cyst
|
||||
|
||||
|
||||
- Coronal MR/CT or US useful to determine organ of origin of large, retroperitoneal cystic lesions
|
||||
|
||||
# PATHOLOGY
|
||||
|
||||
- ## General Features
|
||||
|
||||
|
||||
- ### Etiology
|
||||
|
||||
|
||||
- Congenital (endothelial, epithelial) cysts
|
||||
- Acquired (post hemorrhagic, inflammatory) pseudocysts
|
||||
- Cystic, hemorrhagic degeneration of underlying adrenal neoplasm
|
||||
- ## Staging, Grading, & Classification
|
||||
|
||||
|
||||
- Accepted classification scheme
|
||||
- Pseudocyst
|
||||
- Most common type of cystic adrenal lesion in surgical series
|
||||
- No epithelial or endothelial lining: Fibrous cyst wall
|
||||
- Potentially as complication of prior trauma or hemorrhage though history of such often not elicited
|
||||
- May be associated with underlying adrenal neoplasm (pheochromocytoma, adrenal carcinoma, myelolipoma)
|
||||
- Attenuation and complexity at imaging varies depending upon hemorrhagic component
|
||||
- Wall and septal calcification common
|
||||
- Endothelial cyst
|
||||
- Subtypes: Lymphangiomatous and hemangiomatous
|
||||
- True cyst: Endothelial lining
|
||||
- Originate from preexisting vascular malformation or obstructed, ectatic lymphatic channels
|
||||
- Thin rim calcification typical
|
||||
- Epithelial cyst
|
||||
- Extremely rare: No acinar structures within normal adrenal gland
|
||||
- Mesothelial origin suggested (mesothelial cells potentially incorporated within adrenal gland during embryogenesis)
|
||||
- Parasitic (hydatid) cyst
|
||||
|
||||
# CLINICAL ISSUES
|
||||
|
||||
- ## Presentation
|
||||
|
||||
|
||||
- ### Most common signs/symptoms
|
||||
|
||||
|
||||
- Typically asymptomatic
|
||||
- Larger cysts may be symptomatic
|
||||
- Abdominal pain
|
||||
- Hemorrhage
|
||||
- Clinical history (malignancy, hypertension) elicited
|
||||
- May indicate cystic degeneration of underlying adrenal neoplasm (e.g., metastasis, pheochromocytoma)
|
||||
- Diagnosis
|
||||
- Usually incidental finding at imaging
|
||||
- Endocrine-biochemical evaluation performed to exclude underlying functional adrenal tumor
|
||||
- ## Demographics
|
||||
|
||||
|
||||
- ### Age
|
||||
|
||||
|
||||
- Any, though patients 20-50 years of age most common
|
||||
- ### Sex
|
||||
|
||||
|
||||
- M:F = 1:3
|
||||
- ### Epidemiology
|
||||
|
||||
|
||||
- Uncommon entity: Autopsy incidence 0.064-0.18%
|
||||
- Accounts for 1% of incidental adrenal lesions in large imaging series
|
||||
- ## Natural History & Prognosis
|
||||
|
||||
|
||||
- Complications
|
||||
- Hypertension, infection, rupture, hemorrhage
|
||||
- Excellent prognosis for vast majority of incidental, benign adrenal cysts
|
||||
- Prognosis for pseudocysts secondary to adrenal neoplasm depends upon tumor histology
|
||||
- ## Treatment
|
||||
|
||||
|
||||
- No treatment required usually
|
||||
- Imaging follow-up typically performed
|
||||
- Intensity and length of surveillance not defined
|
||||
- Cysts may enlarge over time
|
||||
- Endocrine evaluation (cortisol, metanephrine, etc.) performed
|
||||
- Surgical resection if symptomatic, underlying adrenal neoplasm
|
||||
- Laparoscopic resection preferred
|
||||
|
||||
# DIAGNOSTIC CHECKLIST
|
||||
|
||||
- ## Consider
|
||||
|
||||
|
||||
- Complicated cyst may suggest underlying adrenal neoplasm
|
||||
- Clinical history, biochemical evaluation, and prior imaging helpful
|
||||
- ## Image Interpretation Pearls
|
||||
|
||||
|
||||
- Simple adrenal cyst: Scant septation, no enhancement, thin rim calcification
|
||||
- Likely benign endothelial cyst or pseudocyst
|
||||
- Coronal imaging helpful to determine organ of origin (and exclude exophytic renal or pancreatic cyst)
|
||||
- Complicated cyst: High attenuation, thick enhancing wall, &/or septations
|
||||
- Complexity may suggest underlying adrenal neoplasm and secondary pseudocyst
|
||||
|
||||
35fa0290-3451-422f-8726-c69b68aadbb5
|
||||
@@ -0,0 +1,234 @@
|
||||
---
|
||||
title: "Adrenal Myelolipoma"
|
||||
docid: "5813a554-06a4-4696-af71-7ce50693039d"
|
||||
breadcrumbs:
|
||||
- "Genitourinary"
|
||||
- "Diagnosis"
|
||||
- "Adrenal"
|
||||
- "Benign Neoplasms"
|
||||
- "Adrenal Myelolipoma"
|
||||
---
|
||||
# KEY FACTS
|
||||
|
||||
- ## Terminology
|
||||
|
||||
|
||||
- Uncommon benign tumor composed of mature fat tissue and hematopoietic elements (myeloid and erythroid cells)
|
||||
- ## Imaging
|
||||
|
||||
|
||||
- Benign, nonfunctioning adrenal tumor
|
||||
- Accounts for 7-15% of incidental adrenal masses, usually in older population
|
||||
- Typically unilateral and very rarely bilateral
|
||||
- Large tumors can mimic retroperitoneal lipomas, liposarcomas
|
||||
- Asymptomatic, though larger tumors may hemorrhage
|
||||
- CT
|
||||
- Lesion containing fat attenuation (-30 to -90 HU)
|
||||
- Usually well-defined mass with recognizable pseudocapsule (remaining adrenal)
|
||||
- Punctate calcifications seen in 24% of cases
|
||||
- Coronal reconstruction helpful to differentiate from exophytic renal angiomyolipoma
|
||||
- MR
|
||||
- Tumor with major fat component
|
||||
- T1WI in phase: Typically hyperintense
|
||||
- FS sequences: Loss of signal
|
||||
- ## Top Differential Diagnoses
|
||||
|
||||
|
||||
- Adrenal adenoma
|
||||
- Intracellular lipid vs. macroscopic fat
|
||||
- Adrenal metastases and lymphoma
|
||||
- Retroperitoneal liposarcoma
|
||||
- Involving perirenal space, may simulate adrenal (or renal) fatty tumor
|
||||
- Pheochromocytoma
|
||||
- Highly vascular, prone to hemorrhage and necrosis
|
||||
- Adrenal carcinoma
|
||||
- Renal angiomyelolipoma
|
||||
- Coronal CT reconstruction or MR useful to determine organ of origin
|
||||
|
||||
# TERMINOLOGY
|
||||
|
||||
- ## Definitions
|
||||
|
||||
|
||||
- Uncommon benign tumor composed of mature adipose tissue and hematopoietic elements
|
||||
|
||||
# IMAGING
|
||||
|
||||
- ## General Features
|
||||
|
||||
|
||||
- ### Best diagnostic clue
|
||||
|
||||
|
||||
- Suprarenal mass containing fat
|
||||
- ### Location
|
||||
|
||||
|
||||
- Suprarenal
|
||||
- Rare extraadrenal myelolipomas (presacral, retroperitoneal)
|
||||
- ### Size
|
||||
|
||||
|
||||
- Usually 2-10 cm, rarely 10-20 cm
|
||||
- Key concepts
|
||||
- Benign neoplasm of adrenal gland
|
||||
- Autopsy prevalence rate of 0.2-0.4%
|
||||
- Accounts for 7-15% of adrenal "incidentalomas"
|
||||
- Usually unilateral incidental finding in older patient
|
||||
- Larger tumors can bleed spontaneously
|
||||
- Most are nonfunctioning (do not secrete hormones)
|
||||
- Large myelolipomas can mimic retroperitoneal lipoma or liposarcoma
|
||||
- ## CT Findings
|
||||
|
||||
|
||||
- CT appearance depends on histologic composition
|
||||
- Most tumors are heterogeneous adrenal masses composed of varying percentages of fat
|
||||
- Low-attenuation suprarenal lesion containing fat density (-30 to -90 HU)
|
||||
- Average NECT attenuation value of tumor: -74 HU in one series
|
||||
- Interspersed soft tissue attenuation components: Myeloid elements, hemorrhage
|
||||
- Presence of macroscopic fat within tumor is diagnostic
|
||||
- Punctate calcifications seen in 24% of cases
|
||||
- Usually well-defined mass with recognizable pseudocapsule (remnant adrenal)
|
||||
- Coronal reconstructions may help determine organ of origin: Adrenal myelolipoma vs. exophytic renal angiomyelolipoma
|
||||
- ## MR Findings
|
||||
|
||||
|
||||
- MR appearance depends on histologic composition
|
||||
- Tumor with major fat component
|
||||
- T1WI in phase: Typically hyperintense
|
||||
- T1WI out phase: Persistent hyperintensity of macroscopic fat
|
||||
- T1WI FS: Confirmatory suppression of signal
|
||||
- Bone marrow elements (myeloid and erythroid cells)
|
||||
- Low signal on T1WI, moderate signal on T2WI
|
||||
- Hemorrhage: Varying T1, T2 signal depending on age of blood
|
||||
- ## Ultrasonographic Findings
|
||||
|
||||
|
||||
- ### Grayscale ultrasound
|
||||
|
||||
|
||||
- Well-defined, echogenic mass (↑ fat tissue)
|
||||
- Often overlooked: Lack of mass effect and isoechogenicity relative to retroperitoneal fat
|
||||
- Heterogeneous mass (↑ myeloid cells)
|
||||
- ## Angiographic Findings
|
||||
|
||||
|
||||
- Conventional
|
||||
- Differentiate myelolipoma from retroperitoneal liposarcoma by determining origin of blood supply and vascularity of tumors
|
||||
- ## Nuclear Medicine Findings
|
||||
|
||||
|
||||
- Typically not metabolically active, though uptake reported at FDG PET
|
||||
- ## Imaging Recommendations
|
||||
|
||||
|
||||
- Helical NECT or MR with FS sequence
|
||||
|
||||
# DIFFERENTIAL DIAGNOSIS
|
||||
|
||||
- [Adrenal Adenoma](/document/adrenal-adenoma/e2916d86-5f9f-4dd3-9576-1a7b89d8dda0)
|
||||
- Lipid-rich adenoma: ↓ attenuation (< 10 HU) at NECT
|
||||
- Can contain small amounts of macroscopic fat due to lipomatous metaplasia
|
||||
- CECT: Washout 15 minutes post injection: > 50%
|
||||
- Relative washout: > 40%
|
||||
- Absolute washout: > 60%
|
||||
- [Metastases and Lymphoma, Adrenal](/document/adrenal-lymphoma/44639c90-bd04-4e2a-a470-2c28a0e2ff78)
|
||||
- Bilateral lesions: Clinical history paramount
|
||||
- Metastases: Soft tissue attenuation (signal)
|
||||
- Lymphoma: May maintain adreniform shape, adjacent retroperitoneal adenopathy
|
||||
- [Liposarcoma, Retroperitoneal](/document/retroperitoneal-sarcoma/c1466b30-b730-41c4-a065-2c2de018a5f7)
|
||||
- Retroperitoneal primary sarcoma involving perirenal space may simulate adrenal (or renal) fatty tumor
|
||||
- [Pheochromocytoma](/document/pheochromocytoma/7d3c4062-643c-4030-8783-f85184ad8132)
|
||||
- Highly vascular, prone to hemorrhage and necrosis
|
||||
- Hyperintense on T2WI, bilateral in multiple endocrine neoplasia syndromes (MEN) syndromes
|
||||
- Clinical history (labile hypertension) and urinary catecholamines
|
||||
- [Adrenal Carcinoma](/document/adrenal-cortical-carcinoma/bdc7a08b-a64f-4bd2-9dfc-24331728e85e)
|
||||
- Rare, unilateral, invasive, enhancing mass
|
||||
- Venous invasion, distant metastases
|
||||
- May contain fat: Engulfed retroperitoneal fat vs. lipomatous metaplasia
|
||||
- ## Renal Angiomyelolipoma
|
||||
|
||||
|
||||
- Exophytic upper pole angiomyolipoma may mimic
|
||||
- Coronal reconstruction/MR helpful to determine organ of origin
|
||||
|
||||
# PATHOLOGY
|
||||
|
||||
- ## General Features
|
||||
|
||||
|
||||
- ### Etiology
|
||||
|
||||
|
||||
- Unknown
|
||||
- Best hypothesis: Reticuloendothelial cell metaplasia of capillaries in adrenal (stress/infection/necrosis)
|
||||
- Secondary hypothesis: Myelolipoma represents site of extramedullary hematopoiesis
|
||||
- ### Associated abnormalities
|
||||
|
||||
|
||||
- Adrenal collision tumors (coexistent myelolipoma and adenoma typical)
|
||||
- Large, bilateral myelolipomas reported with longstanding, poorly treated congenital adrenal hyperplasia
|
||||
- ## Gross Pathologic & Surgical Features
|
||||
|
||||
|
||||
- Cut section: Fat, soft tissue components
|
||||
- ## Microscopic Features
|
||||
|
||||
|
||||
- Mature fat cells and megakaryocytes; no malignant cells
|
||||
- Calcification
|
||||
- Hemorrhage within larger lesions
|
||||
|
||||
# CLINICAL ISSUES
|
||||
|
||||
- ## Presentation
|
||||
|
||||
|
||||
- ### Most common signs/symptoms
|
||||
|
||||
|
||||
- Asymptomatic
|
||||
- Usually incidental finding on CT, MR
|
||||
- Typically biochemically nonfunctioning
|
||||
- Symptomatic
|
||||
- Acute abdomen: Flank pain due to rupture and hemorrhage
|
||||
- Case reports of hormonally active tumors: Cushing, Conn syndromes, virilization
|
||||
- Diagnosis: Pathognomonic MR/CT features
|
||||
- Biopsy reserved for larger, atypical lesions, though prone to sampling error
|
||||
- ## Demographics
|
||||
|
||||
|
||||
- ### Age
|
||||
|
||||
|
||||
- Usually older patients (50-70 years old)
|
||||
- ### Epidemiology
|
||||
|
||||
|
||||
- Autopsy incidence: 0.2-0.4%
|
||||
- ## Natural History & Prognosis
|
||||
|
||||
|
||||
- Complication: Rupture with hemorrhage (rare)
|
||||
- Prognosis: Excellent
|
||||
- ## Treatment
|
||||
|
||||
|
||||
- When diagnosis is certain, surgery not needed for lesions < 5-7 cm
|
||||
- Surgery reserved for larger, symptomatic, or atypical lesions
|
||||
- Surgical series have confirmed utility of laparoscopic resection
|
||||
|
||||
# DIAGNOSTIC CHECKLIST
|
||||
|
||||
- ## Consider
|
||||
|
||||
|
||||
- Differentiate from other tumors (lipid-rich adenoma)
|
||||
- Key is presence of imaging-apparent adipose tissue; avoid further work-up for incidental mass
|
||||
- ## Image Interpretation Pearls
|
||||
|
||||
|
||||
- Well-defined, heterogeneous, fat-attenuation tumor on CT
|
||||
- T1 hyperintense, signal loss with fat suppression
|
||||
|
||||
81ce3ad3-c446-4b08-8b87-df9511f95360
|
||||
@@ -0,0 +1,113 @@
|
||||
---
|
||||
title: "Adrenal"
|
||||
docid: "082ca43c-db5c-4770-aeed-0c6ea317e8fc"
|
||||
breadcrumbs:
|
||||
- "Genitourinary"
|
||||
- "Anatomy"
|
||||
- "Adrenal"
|
||||
---
|
||||
# TERMINOLOGY
|
||||
|
||||
- ## Abbreviations
|
||||
|
||||
|
||||
- Adrenal corticotrophic hormone (ACTH)
|
||||
|
||||
# GROSS ANATOMY
|
||||
|
||||
- ## Overview
|
||||
|
||||
|
||||
- Adrenal (**suprarenal**) glands are part of endocrine and neurological systems
|
||||
- Essentially different organs within same structure, composed of thick outer cortex and thin inner medulla
|
||||
- Lie within**perirenal space**bilaterally, bounded by**renal** (**perirenal**)**fascia**, above/medial to kidneys
|
||||
- Composed of "body" and 2 limbs (medial and lateral)
|
||||
- ## Anatomic Relationships
|
||||
|
||||
|
||||
- Right adrenal is usually more apical in location
|
||||
- Lies anterolateral to right crus of diaphragm, medial to liver, and posterior to inferior vena cava (IVC)
|
||||
- Often pyramidal in shape with inverted V shape on transverse section
|
||||
- Left adrenal is usually more caudal and lies medial to upper pole of left kidney, lateral to left crus of diaphragm, and posterior to splenic vein and pancreas
|
||||
- Often crescentic in shape with λ or triangular shape on transverse section
|
||||
- ## Divisions
|
||||
|
||||
|
||||
- **Adrenal cortex**
|
||||
- Embryologically derived from mesoderm
|
||||
- Divided into 3 distinct zones (zona glomerulosa, zona fasciculata, and zona reticularis)
|
||||
- Secretes **mineralocorticoids**(aldosterone) from zona glomerulosa, **glucocorticoids**(cortisol) from zona fasciculata, and **androgens**from zona reticularis
|
||||
- **Adrenal medulla**
|
||||
- Embryologically derived from neural crest
|
||||
- Part of sympathetic nervous system
|
||||
- **Chromaffin cells** secrete **catecholamines** (mostly epinephrine) into bloodstream
|
||||
- **Vessels**,**nerves**, and **lymphatics**
|
||||
- Arteries
|
||||
- **Superior adrenal arteries**: Typically 6-8; from inferior phrenic arteries
|
||||
- **Middle adrenal artery**: 1; from abdominal aorta
|
||||
- **Inferior adrenal artery**: 1; from renal arteries
|
||||
- Veins
|
||||
- **Right adrenal vein** drains into IVC
|
||||
- **Left adrenal vein** drains into left renal vein (usually after joining left inferior phrenic vein)
|
||||
- Nerves
|
||||
- Extensive sympathetic connection to adrenal medulla
|
||||
- Presynaptic sympathetic fibers from paravertebral ganglia end directly on secretory cells of medulla
|
||||
- Lymphatics
|
||||
- Drain to **lumbar** (**aortic** and **caval**) **nodes**
|
||||
|
||||
# ANATOMY IMAGING ISSUES
|
||||
|
||||
- ## Multimodality Imaging Appearance
|
||||
|
||||
|
||||
- No consensus on "normal" size or thickness of adrenals but average thickness of ~ 3 mm for medial/lateral limbs
|
||||
- While not based on any strong evidence, > 10-mm thickness can be used as threshold for hyperplasia
|
||||
- MR: Generally isointense to liver on T1 MR and isointense to slightly hyperintense to liver on T2 MR
|
||||
- Ultrasound: Easiest to visualize in newborns (as result of physiologic enlargement) and become progressively more difficult to visualize with age
|
||||
- Right adrenal gland easier to visualize than left (due to lack of liver as acoustic window and overlying bowel gas)
|
||||
- Adrenal glands in adults usually hypoechoic (juxtaposed against hyperechoic periadrenal fat), although medulla can rarely be discretely seen and appears hyperechoic
|
||||
- ## Key Concepts
|
||||
|
||||
|
||||
- **Adrenal** (**cortical**) **adenomas**
|
||||
- Very common (at least 2% of general population) but usually cause no symptoms
|
||||
- Mostly "nonfunctioning" but identical to "functional" adenomas that cause Cushing/Conn syndrome
|
||||
- Most adenomas contain abundant lipid (precursor to steroid hormones), allowing definitive diagnosis using CT/MR sequences that highlight lipid
|
||||
- Lipid is intracellular/intercellular (not macroscopic deposits of fat)
|
||||
- Best CT technique: Nonenhanced CT with nodule measuring < 10 HU; or multiphase-enhanced CT with nodule demonstrating "washout" kinetics
|
||||
- Best MR technique: Chemical-shift MR with signal dropout within nodule on opposed-phase images
|
||||
- Standard imaging features for diagnosis of adenoma should be used for nodules measuring < 4 cm, while lesions > 4 cm should raise concern for malignancy
|
||||
- **Pheochromocytoma** (tumor of adrenal medulla)
|
||||
- Signs: Headache, palpitations, excessive perspiration
|
||||
- 90% arise in adrenal, 90% unilateral, 90% benign
|
||||
- Similar tumor arising in other chromaffin cells of sympathetic ganglia is called **paraganglioma**
|
||||
- More common with multiple endocrine neoplasia, neurofibromatosis, and von Hippel-Lindau
|
||||
- Often markedly hypervascular in arterial phase
|
||||
- **Adrenal myelolipoma**
|
||||
- Uncommon benign tumor (usually incidental finding) composed of mature adipose and hematopoietic tissue
|
||||
- Characterized by presence of **macroscopic fat**
|
||||
- May have internal soft tissue component or calcification
|
||||
- **Adrenocortical carcinoma**
|
||||
- Highly aggressive malignancy with poor prognosis
|
||||
- Large, heterogeneous mass (often with necrosis, hemorrhage, or calcification) with frequent local invasion, vascular invasion, and distant metastases
|
||||
- **Cushing syndrome** (excess cortisol)
|
||||
- Signs: Truncal obesity, hirsutism, hypertension
|
||||
- Causes: Pituitary tumors (→ adrenal corticotrophic hormone), exogenous (medications) > adrenal adenoma > carcinoma
|
||||
- **Conn syndrome** (excess aldosterone)
|
||||
- Signs: Hypertension, hypokalemic alkalosis
|
||||
- Causes: Adrenal adenomas > hyperplasia > carcinoma
|
||||
- **Addison syndrome**(adrenal insufficiency)
|
||||
- Signs: Hypotension, weight loss, altered pigmentation
|
||||
- Causes: Autoimmune disease > adrenal metastases > adrenal hemorrhage > adrenal infection
|
||||
|
||||
# CLINICAL IMPLICATIONS
|
||||
|
||||
- ## Clinical Importance
|
||||
|
||||
|
||||
- Rich adrenal blood supply due to endocrine function
|
||||
- Results in adrenal glands being common site for hematologic **metastases** (lung, breast, melanoma, etc.)
|
||||
- Adrenal glands respond to stress (trauma, sepsis, surgery, etc.) by secreting ↑ cortisol and epinephrine
|
||||
- Overwhelming stress may result in **adrenal hemorrhage**or acute adrenal insufficiency (addisonian crisis)
|
||||
|
||||
d7703d36-250d-428e-bf99-6439a7cdc980
|
||||
-19
@@ -1,19 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/24559f7a-ed5a-4ab6-90ba-769f0b5c1197/media"
|
||||
---
|
||||
[
|
||||
{
|
||||
"groupId": "e2f10f6a-0bef-498b-9eb3-1b9558473bfa",
|
||||
"name": "Selected Images",
|
||||
"images": [
|
||||
{
|
||||
"imageId": "444b7609-9961-4277-a969-7a56d10a6b02",
|
||||
"caption": "Axial T2 MR shows a cluster of CSF-like cysts in the inferior left basal ganglia , a common location for enlarged perivascular spaces. They are often seen at the level of the anterior commissure.",
|
||||
"title": "Enlarged Perivascular Spaces",
|
||||
"enhancedTitle": "Enlarged Perivascular Spaces",
|
||||
"annotated": true,
|
||||
"flanked": false,
|
||||
"documentId": "24559f7a-ed5a-4ab6-90ba-769f0b5c1197",
|
||||
"documentUrl": "/document/v2/24559f7a-ed5a-4ab6-90ba-769f0b5c1197",
|
||||
"imageTitle": "Enlarged Perivascular Spaces",
|
||||
"thumbnailUrl": "
|
||||
-19
@@ -1,19 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/24559f7a-ed5a-4ab6-90ba-769f0b5c1197/media"
|
||||
---
|
||||
[
|
||||
{
|
||||
"groupId": "e2f10f6a-0bef-498b-9eb3-1b9558473bfa",
|
||||
"name": "Selected Images",
|
||||
"images": [
|
||||
{
|
||||
"imageId": "444b7609-9961-4277-a969-7a56d10a6b02",
|
||||
"caption": "Axial T2 MR shows a cluster of CSF-like cysts in the inferior left basal ganglia , a common location for enlarged perivascular spaces. They are often seen at the level of the anterior commissure.",
|
||||
"title": "Enlarged Perivascular Spaces",
|
||||
"enhancedTitle": "Enlarged Perivascular Spaces",
|
||||
"annotated": true,
|
||||
"flanked": false,
|
||||
"documentId": "24559f7a-ed5a-4ab6-90ba-769f0b5c1197",
|
||||
"documentUrl": "/document/v2/24559f7a-ed5a-4ab6-90ba-769f0b5c1197",
|
||||
"imageTitle": "Enlarged Perivascular Spaces",
|
||||
"thumbnailUrl": "
|
||||
-19
@@ -1,19 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/49510d0e-acf7-45cb-9eb1-53f8193b0b6d/media"
|
||||
---
|
||||
[
|
||||
{
|
||||
"groupId": "415b02cf-df4f-4cef-9c2b-866ef0618ec0",
|
||||
"name": "Selected Images",
|
||||
"images": [
|
||||
{
|
||||
"imageId": "ccf3ab42-d18d-44f4-9b3f-cc9fd9510d11",
|
||||
"caption": "Graphic depicts the classic disproportionate frontal lobe atrophy of late-stage frontotemporal dementia (FTD). The sulci are widened & gyri are knife-like . Parietooccipital lobes are spared. Gyri around the central sulcus are normal.",
|
||||
"title": "",
|
||||
"enhancedTitle": "",
|
||||
"annotated": true,
|
||||
"flanked": false,
|
||||
"documentId": "49510d0e-acf7-45cb-9eb1-53f8193b0b6d",
|
||||
"documentUrl": "/document/v2/49510d0e-acf7-45cb-9eb1-53f8193b0b6d",
|
||||
"imageTitle": "",
|
||||
"thumbnailUrl": "/image/thumbnail/ccf3ab42-d18d-44f4-9b3f-
|
||||
-10
@@ -1,10 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/49510d0e-acf7-45cb-9eb1-53f8193b0b6d/tables"
|
||||
---
|
||||
[
|
||||
"
|
||||
# Imaging Features for Various Clinical Subtypes of Frontotemporal Dementia
|
||||
|
||||
| Clinical Subtypes | Imaging Features |
|
||||
| --- | --- |
|
||||
| bvFTD | MR: Atrophy of frontal & temporal lobes; asymmetric right frontal &/or temporal lobe atrophy may occur NM: Decreased perfusion & metabolism in frontal &/or te |
|
||||
-20
@@ -1,20 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/9f9eda8c-7e3c-4292-9861-4b8abc2c6474/media"
|
||||
---
|
||||
[
|
||||
{
|
||||
"groupId": "fb01ca50-5af0-419d-ad89-6f4f2d980fd2",
|
||||
"name": "Selected Images",
|
||||
"images": [
|
||||
{
|
||||
"imageId": "01274ce7-fce5-4f42-bd69-b5a99e6a4930",
|
||||
"caption": "Axial F-18 FDG PET shows findings associated with frontotemporal dementia (FTD), predominantly frontal  and temporal lobe hypometabolism. Functional changes may occur prior to CT or MR changes.",
|
||||
"title": "",
|
||||
"enhancedTitle": "",
|
||||
"annotated": true,
|
||||
"flanked": false,
|
||||
"documentId": "9f9eda8c-7e3c-4292-9861-4b8abc2c6474",
|
||||
"documentUrl": "/document/v2/9f9eda8c-7e3c-4292-9861-4b8abc2c6474",
|
||||
"imageTitle": "",
|
||||
"thumbnailUrl": "/image/thumbnail/01274ce7-fce5-4f42-bd69-b5a99e6a4930?size=168&quality=85"
|
||||
},
|
||||
-14
@@ -1,14 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/content/24559f7a-ed5a-4ab6-90ba-769f0b5c1197"
|
||||
---
|
||||
# ESSENTIAL INFORMATION
|
||||
|
||||
- ## Key Differential Diagnosis Issues
|
||||
|
||||
|
||||
- Key imaging questions
|
||||
- Does lesion follow CSF on all modalities/sequences?
|
||||
- Is there any associated mass effect?
|
||||
- Does lesion enhance?
|
||||
|
||||
</l
|
||||
-14
@@ -1,14 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/content/24559f7a-ed5a-4ab6-90ba-769f0b5c1197"
|
||||
---
|
||||
# ESSENTIAL INFORMATION
|
||||
|
||||
- ## Key Differential Diagnosis Issues
|
||||
|
||||
|
||||
- Key imaging questions
|
||||
- Does lesion follow CSF on all modalities/sequences?
|
||||
- Is there any associated mass effect?
|
||||
- Does lesion enhance?
|
||||
|
||||
</l
|
||||
-10
@@ -1,10 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/content/834ccc3e-2116-4295-8408-0ac9a06bd2ff"
|
||||
---
|
||||
# KEY FACTS
|
||||
|
||||
- ## Terminology
|
||||
|
||||
|
||||
- Normal-pressure hydrocephalus (NPH): Ventriculomegaly out of proportion to sulcal enlargement in setting of normal cerebrospinal fluid (CSF) pressure
|
||||
- ## Imaging</h
|
||||
-10
@@ -1,10 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/content/9f9eda8c-7e3c-4292-9861-4b8abc2c6474"
|
||||
---
|
||||
# KEY FACTS
|
||||
|
||||
- ## Terminology
|
||||
|
||||
|
||||
- Frontotemporal dementia (FTD): Progressive neurodegenerative disorder of frontal/anterior temporal lobes
|
||||
- ## Imaging
|
||||
-10
@@ -1,10 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/content/a1bedda5-6478-40b2-98e7-6c5f5363b06f"
|
||||
---
|
||||
# IMAGING ANATOMY
|
||||
|
||||
- ## Overview
|
||||
|
||||
|
||||
- Attention control network is a constellation of distributed brain networks processing attention to external stimuli and symbols
|
||||
- Many aliases: Task-positive network, frontoparietal network, executive control network, and central executiv
|
||||
-10
@@ -1,10 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/content/a1bedda5-6478-40b2-98e7-6c5f5363b06f"
|
||||
---
|
||||
# IMAGING ANATOMY
|
||||
|
||||
- ## Overview
|
||||
|
||||
|
||||
- Attention control network is a constellation of distributed brain networks processing attention to external stimuli and symbols
|
||||
- Many aliases: Task-positive network, frontoparietal network, executive control network, and central executiv
|
||||
-10
@@ -1,10 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/content/e1b27954-6591-4bb0-a659-b13790492620"
|
||||
---
|
||||
# KEY FACTS
|
||||
|
||||
- ## Terminology
|
||||
|
||||
|
||||
- Creutzfeldt-Jakob disease (CJD): Rapidly progressing, fatal, potentially transmissible dementia caused by prion
|
||||
- ## Imaging
|
||||
-11
@@ -1,11 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/content/e8e46d1d-46d2-4e5a-880f-f025a84c5871"
|
||||
---
|
||||
# KEY FACTS
|
||||
|
||||
- ## Terminology
|
||||
|
||||
|
||||
- Progressive neurodegenerative dementia
|
||||
- Parkinsonism, visual hallucinations prominent
|
||||
- Caused by abnormal accumulation of α-synuclein protein
|
||||
-17
@@ -1,17 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/e1b27954-6591-4bb0-a659-b13790492620/media"
|
||||
---
|
||||
[
|
||||
{
|
||||
"groupId": "a8f1dd51-2e0e-4f07-af00-6623d1c4e2d4",
|
||||
"name": "Selected Images",
|
||||
"images": [
|
||||
{
|
||||
"imageId": "e4dd9275-5048-4513-8288-980aa8250267",
|
||||
"caption": "A 53-year-old man with rapidly progressing cognitive decline due to sporadic Creutzfeldt-Jakob disease (sCJD) is shown. Axial DWI MR demonstrates symmetric bilateral basal ganglia (BG) diffusion restriction  and asymmetric cortical restricted diffusion (cortical ribbon sign) in bilateral (right > > left) hemispheres .",
|
||||
"title": "",
|
||||
"enhancedTitle": "",
|
||||
"annotated": true,
|
||||
"flanked": false,
|
||||
"documentId": "e1b27954-6591-4bb0-a659-b13790492620",
|
||||
"documentUrl": "/document/v2/e1b27954-6591
|
||||
-14
@@ -1,14 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/e8e46d1d-46d2-4e5a-880f-f025a84c5871/media"
|
||||
---
|
||||
[
|
||||
{
|
||||
"groupId": "210f7378-e2e6-472b-b1ad-2571bafd02be",
|
||||
"name": "Selected Images",
|
||||
"images": [
|
||||
{
|
||||
"imageId": "d2ff700c-f618-401b-94df-595198c45827",
|
||||
"caption": "Right & left medial sagittal FDG PET source & 3DSSP images of a 74-year-old man with dementia with Lewy bodies (DLB) presenting with visual hallucinations show severe ↓ metabolic activity in left visual cortex  & precuneus . Note moderate ↓ metabolic activity in right occipital lobe  & precuneus  & relative sparing of bilateral posterior cingulate gyri .",
|
||||
"title": "",
|
||||
"enhancedTitle": "",
|
||||
"annotated":
|
||||
-19
@@ -1,19 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/document/f59dab57-c511-4369-8fcc-592421a4b8d1/media"
|
||||
---
|
||||
[
|
||||
{
|
||||
"groupId": "bce2eb1d-5b42-493d-b6f2-86c7fb747dcb",
|
||||
"name": "Selected Images",
|
||||
"images": [
|
||||
{
|
||||
"imageId": "add7af59-3e22-4ebd-bda3-585280f734e0",
|
||||
"caption": "Axial graphic of vascular dementia (VaD) shows diffuse cerebral atrophy, focal volume loss due to multiple chronic infarcts , an acute left occipital lobe infarct , and small lacunar infarcts in the basal ganglia/thalami .",
|
||||
"title": "",
|
||||
"enhancedTitle": "",
|
||||
"annotated": true,
|
||||
"flanked": false,
|
||||
"documentId": "f59dab57-c511-4369-8fcc-592421a4b8d1",
|
||||
"documentUrl": "/document/v2/f59dab57-c511-4369-8fcc-592421a4b8d1",
|
||||
"imageTitle": "",
|
||||
"thumbnailUr
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
Vendored
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/main"
|
||||
---
|
||||
html
|
||||
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/tree/brain/6d8829f1-14d7-45af-8675-255189aa526a"
|
||||
---
|
||||
html
|
||||
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/tree/brain/6d8829f1-14d7-45af-8675-255189aa526a"
|
||||
---
|
||||
html
|
||||
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/tree/brain/6d8829f1-14d7-45af-8675-255189aa526a"
|
||||
---
|
||||
html
|
||||
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/tree/brain/6d8829f1-14d7-45af-8675-255189aa526a"
|
||||
---
|
||||
html
|
||||
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/tree/brain/6d8829f1-14d7-45af-8675-255189aa526a"
|
||||
---
|
||||
html
|
||||
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/tree/brain/6d8829f1-14d7-45af-8675-255189aa526a"
|
||||
---
|
||||
html
|
||||
-4
@@ -1,4 +0,0 @@
|
||||
---
|
||||
title: "https://app.statdx.com/tree/brain/6d8829f1-14d7-45af-8675-255189aa526a"
|
||||
---
|
||||
html
|
||||
@@ -87,6 +87,30 @@ async def run(args):
|
||||
await asyncio.sleep(5)
|
||||
async with capture_count_lock:
|
||||
print(f"[heartbeat] captured={capture_count}")
|
||||
|
||||
# Build an in-memory index of content_hash -> list of index entries for quick dedupe lookups.
|
||||
# If older index lines lack a content_hash but reference a body file, hash that file once at startup.
|
||||
in_memory_index = {}
|
||||
try:
|
||||
if index_path.exists():
|
||||
with open(index_path, 'r', encoding='utf-8') as idxf:
|
||||
for line in idxf:
|
||||
try:
|
||||
j = json.loads(line)
|
||||
except Exception:
|
||||
continue
|
||||
ch = j.get('content_hash')
|
||||
body = j.get('body_file')
|
||||
if not ch and body and os.path.exists(body):
|
||||
try:
|
||||
with open(body, 'rb') as bf:
|
||||
ch = hashlib.sha256(bf.read()).hexdigest()
|
||||
except Exception:
|
||||
ch = None
|
||||
if ch:
|
||||
in_memory_index.setdefault(ch, []).append(j)
|
||||
except Exception:
|
||||
in_memory_index = {}
|
||||
|
||||
async with async_playwright() as p:
|
||||
browser_type = p.chromium
|
||||
@@ -102,6 +126,82 @@ async def run(args):
|
||||
|
||||
page = await context.new_page()
|
||||
|
||||
async def attempt_autologin(page, username: str, password: str, post_login_selector: str, wait_after: float = 1.0):
|
||||
"""Async form-based autologin similar to save_page_snapshots.attempt_autologin."""
|
||||
if not username or not password:
|
||||
return False
|
||||
# selectors
|
||||
user_selectors = ['input[name="username"]', 'input.usernameSelector', 'input[type="email"]', 'input[name*="email" i]', 'input[name*="user" i]', 'input[type="text"]']
|
||||
pass_selectors = ['input[type="password"]', 'input[name="password"]', 'input.passwordSelector']
|
||||
|
||||
user_sel = None
|
||||
for sel in user_selectors:
|
||||
try:
|
||||
el = await page.query_selector(sel)
|
||||
if el:
|
||||
user_sel = sel
|
||||
break
|
||||
except Exception:
|
||||
continue
|
||||
|
||||
pass_sel = None
|
||||
for sel in pass_selectors:
|
||||
try:
|
||||
el = await page.query_selector(sel)
|
||||
if el:
|
||||
pass_sel = sel
|
||||
break
|
||||
except Exception:
|
||||
continue
|
||||
|
||||
if not user_sel or not pass_sel:
|
||||
try:
|
||||
with open(output / '_debug_events.log', 'a', encoding='utf-8') as dbg:
|
||||
dbg.write(f"{now_ts()}\tAUTOLOGIN\tselectors_missing\n")
|
||||
except Exception:
|
||||
pass
|
||||
return False
|
||||
|
||||
try:
|
||||
await page.fill(user_sel, username)
|
||||
await asyncio.sleep(0.1)
|
||||
await page.fill(pass_sel, password)
|
||||
await asyncio.sleep(0.1)
|
||||
# try submit
|
||||
submit_selectors = ['button[type=submit]', 'input[type=submit]', 'button:has-text("Sign in")', 'button:has-text("Sign In")', 'button:has-text("Log in")']
|
||||
clicked = False
|
||||
for s in submit_selectors:
|
||||
try:
|
||||
btn = await page.query_selector(s)
|
||||
if btn:
|
||||
await btn.click()
|
||||
clicked = True
|
||||
break
|
||||
except Exception:
|
||||
continue
|
||||
if not clicked:
|
||||
try:
|
||||
await page.press(pass_sel, 'Enter')
|
||||
except Exception:
|
||||
pass
|
||||
|
||||
# wait for post-login selector
|
||||
try:
|
||||
if post_login_selector:
|
||||
await page.wait_for_selector(post_login_selector, timeout=10000)
|
||||
except Exception:
|
||||
pass
|
||||
await asyncio.sleep(wait_after)
|
||||
return True
|
||||
except Exception:
|
||||
try:
|
||||
with open(output / '_debug_events.log', 'a', encoding='utf-8') as dbg:
|
||||
dbg.write(f"{now_ts()}\tAUTOLOGIN\tfailed_exception\n")
|
||||
except Exception:
|
||||
pass
|
||||
return False
|
||||
|
||||
|
||||
async def on_response(resp):
|
||||
nonlocal capture_count
|
||||
try:
|
||||
@@ -237,6 +337,51 @@ async def run(args):
|
||||
# skip if still failing
|
||||
return
|
||||
|
||||
# compute content hash for dedupe
|
||||
content_hash = None
|
||||
try:
|
||||
if 'txt' in locals() and isinstance(txt, str):
|
||||
content_hash = hashlib.sha256(txt.encode('utf-8')).hexdigest()
|
||||
elif 'pretty' in locals() and isinstance(pretty, str):
|
||||
content_hash = hashlib.sha256(pretty.encode('utf-8')).hexdigest()
|
||||
elif 'data' in locals() and isinstance(data, (bytes, bytearray)):
|
||||
content_hash = hashlib.sha256(data).hexdigest()
|
||||
except Exception:
|
||||
content_hash = None
|
||||
|
||||
# prepare the meta filename we'll write for this response
|
||||
new_meta_name = f"{safe}_{h}_{ts}.meta.json"
|
||||
new_meta_abs = os.path.abspath(str(output / new_meta_name))
|
||||
|
||||
# If older responses exist with the same content, delete them (fast in-memory lookup)
|
||||
try:
|
||||
matches = in_memory_index.get(content_hash, []) if content_hash else []
|
||||
for j in matches:
|
||||
body = j.get('body_file')
|
||||
metaf = j.get('meta_file')
|
||||
try:
|
||||
if body and os.path.exists(body) and os.path.abspath(body) != os.path.abspath(body_path):
|
||||
os.remove(body)
|
||||
try:
|
||||
with open(output / '_debug_events.log', 'a', encoding='utf-8') as dbg:
|
||||
dbg.write(f"{now_ts()}\tDELETED_OLD_BODY\t{body}\n")
|
||||
except Exception:
|
||||
pass
|
||||
except Exception:
|
||||
pass
|
||||
try:
|
||||
if metaf and os.path.exists(metaf) and os.path.abspath(metaf) != new_meta_abs:
|
||||
os.remove(metaf)
|
||||
try:
|
||||
with open(output / '_debug_events.log', 'a', encoding='utf-8') as dbg:
|
||||
dbg.write(f"{now_ts()}\tDELETED_OLD_META\t{metaf}\n")
|
||||
except Exception:
|
||||
pass
|
||||
except Exception:
|
||||
pass
|
||||
except Exception:
|
||||
pass
|
||||
|
||||
meta = {
|
||||
'url': url,
|
||||
'resource_type': rtype,
|
||||
@@ -245,12 +390,17 @@ async def run(args):
|
||||
'response_headers': resp_headers,
|
||||
'response_body_file': body_path,
|
||||
'response_excerpt': excerpt,
|
||||
'content_hash': content_hash,
|
||||
}
|
||||
meta_name = f"{safe}_{h}_{ts}.meta.json"
|
||||
save_text(output / meta_name, json.dumps(meta, ensure_ascii=False, indent=2))
|
||||
try:
|
||||
entry = {'url': url, 'resource_type': rtype, 'timestamp': ts, 'body_file': body_path, 'meta_file': str(output / meta_name), 'excerpt': excerpt, 'content_hash': content_hash}
|
||||
with open(index_path, 'a', encoding='utf-8') as idx:
|
||||
idx.write(json.dumps({'url': url, 'resource_type': rtype, 'timestamp': ts, 'body_file': body_path, 'meta_file': str(output / meta_name), 'excerpt': excerpt}, ensure_ascii=False) + '\n')
|
||||
idx.write(json.dumps(entry, ensure_ascii=False) + '\n')
|
||||
# update in-memory index
|
||||
if content_hash:
|
||||
in_memory_index.setdefault(content_hash, []).append(entry)
|
||||
except Exception:
|
||||
pass
|
||||
|
||||
@@ -290,6 +440,20 @@ async def run(args):
|
||||
except Exception:
|
||||
pass
|
||||
|
||||
# attempt autologin (form-based) if credentials provided
|
||||
uname = args.username or os.getenv('STATDX_USERNAME')
|
||||
pwd = args.password or os.getenv('STATDX_PASSWORD')
|
||||
if uname and pwd:
|
||||
try:
|
||||
ok = await attempt_autologin(page, uname, pwd, args.post_login_selector)
|
||||
try:
|
||||
with open(output / '_debug_events.log', 'a', encoding='utf-8') as dbg:
|
||||
dbg.write(f"{now_ts()}\tAUTOLOGIN_RESULT\t{ok}\n")
|
||||
except Exception:
|
||||
pass
|
||||
except Exception:
|
||||
pass
|
||||
|
||||
# If interactive, let user log in; otherwise start capture immediately
|
||||
if not args.no_prompt:
|
||||
print('When you have logged in in the opened browser, press Enter here to continue and capture...')
|
||||
@@ -325,6 +489,9 @@ def parse_args():
|
||||
parser.add_argument('--headless', action='store_true')
|
||||
parser.add_argument('--continuous', action='store_true')
|
||||
parser.add_argument('--no-prompt', action='store_true')
|
||||
parser.add_argument('--username', help='STATdx username (or use STATDX_USERNAME env var)')
|
||||
parser.add_argument('--password', help='STATdx password (or use STATDX_PASSWORD env var)')
|
||||
parser.add_argument('--post-login-selector', default='#ds-app', help='Selector that indicates a successful login')
|
||||
parser.add_argument('--channel', default=os.getenv('PLAYWRIGHT_CHROME_CHANNEL', 'chrome'))
|
||||
parser.add_argument('--capture-types', default='xhr,fetch,document,other')
|
||||
return parser.parse_args()
|
||||
|
||||
Reference in New Issue
Block a user