Learning objectives
- To summarize the appropriate imaging approach of adrenal masses.
- To illustrate and to describe the imaging features of the wide spectrum of adrenal lesions on computed tomography (CT) and magnetic resonance (MR) with histologic correlation.
Background
Adrenal glands are a common site of disease.
The detection of adrenal masses has increased with the expanding use of cross-sectional imaging.
Adrenal incidentalomas are asymptomatic masses discovered on imaging studies performed for reasons unrelated to adrenal disease,
and have a prevalence in the general population of 3% to 7%.
The majority of incidental adrenal masses are benign and are most commonly adenomas.
However,
adrenal gland is also a common site of metastases.
Additionally,
primary malignant adrenal neoplasms can also occur.
Once an adrenal lesion...
Imaging findings OR Procedure details
Imaging findings
Adrenal Adenoma
Adrenal adenomas are the most common adrenal lesions.
Functioning adenomas (Cushing syndrome,
Conn syndrome) are uncommon and usually can be confirmed by means of biochemical evaluation in the presence of an adrenal mass.
There are no specific morphologic features that permit adenoma characterization,
because the majority is small,
smooth,
and homogeneous when detected.
However,
most can be characterized by using lipid-sensitive or washout CT techniques or chemical shift MR techniques.
CT findings:
Adenomas are typically well-defined,
often homogeneous and may have...
Conclusion
A cross-sectional imaging systematic approach is fundamental in the evaluation and characterization of adrenal masses.
The analysis of their imaging features,
either on CT or on MR imaging,
in association with the acknowledge of the patient clinical context (particularly history of malignancy),
are crucial to determinate the benign or malignant nature of these lesions,
thus allowing a correct diagnosis and an appropriate management.
References
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Song JH,
Mayo-Smith,
WW.
Incidentally Discovered Adrenal Mass.
Radiol Clin N Am 49 (2011) 361–368.
2.
Boland GWL,
Blake MA,
Hahn,
PF,
Mayo-Smith WW.
Incidental Adrenal Lesions: Principles,
Techniques,
and Algorithms for Imaging Characterization.
Radiology 2008 December; Volume 249: Number 3.
3.
Dunnick NR,
Korobkin M.
Imaging of Adrenal Incidentalomas: Current Status.
AJR 2002; 179:559–568.
4.
Mayo-Smith WW,
Boland GW,
Noto RB,
et al.
State-of-the-Art Adrenal Imaging.
RadioGraphics 2001; 21:995–1012.
5.
Johnson PT,
Horton KM,
Fishman EK.
Adrenal Mass Imaging with Multidetector CT: Pathologic...
Personal Information
Marta Morna Palmeiro,Serviço de Radiologia,
Director: Dr.
José Venâncio,
Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E.,
Lisbon,
Portugal;
[email protected]
João Niza,Serviço de Radiologia,
Director: Dr.
José Venâncio,
Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E.,
Lisbon,
Portugal;
[email protected]
Vasco Marques,Serviço de Radiologia,
Director: Dr.
José Venâncio,
Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E.,
Lisbon,
Portugal;
[email protected]
Elisa Melo Abreu,Serviço de Radiologia,
Director: Dr.
José Venâncio,
Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E.,
Lisbon,
Portugal;
[email protected]
Ana Loureiro,Serviço de...