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Reproductive/Endocrine Imaging

E2614. CT and MRI of Adrenal Tumors: A Pictorial Essay

Mkpolulu C1,  Ochiobi C1,  Chu L.2 1. Lake Medical Imaging, Leesburg, FL; 2. Johns Hopkins University, Baltimore, MD

Address correspondence to C. Mkpolulu (mkpolulu@gmail.com)

Background Information: The adrenal glands are common sites of disease in the human body and are well visualized in every abdominal CT and MRI study. With the increased use of CT and MRI, there has been increased detection of adrenal tumors overtime, and radiologists are faced with the task of determining their etiologic factors. These tumors often pose diagnostic challenges to inexperienced radiologists and radiology residents in training, resulting in inaccurate diagnosis, unnecessary additional imaging or intervention, and delayed or poor patient management. The purpose of this presentation is to familiarize the viewer with the imaging appearances and presentations of adrenal tumors on CT and MRI, the appropriate imaging protocol for imaging adrenal tumors, and their clinical significance.

Educational Goals/Teaching Points: The goals of this presentation are to review the normal anatomy of the adrenal gland and the CT and MRI protocols for imaging adrenal tumors. We will illustrate appearances of different types of adrenal tumors on CT and MRI. Lastly, we will describe the clinical significance of various adrenal tumors including associated syndromic disorders.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: In this exhibit, we will review the anatomy of the adrenal gland, CT and MRI protocols for adrenal tumors, and the clinical presentations, imaging appearances, and clinical significance of adrenal masses. Examples to be discussed include fat-containing adrenal tumors like adenoma and myelomyolipoma, cystic adrenal tumors like lymphangioma, adreniform tumors like adrenal hyperplasia and adrenal hemorrhage, and pheochromocytoma and malignant adrenal lesions like adrenal cortical carcinoma and metastasis.

Conclusion: Adrenal tumors are frequently encountered in every day imaging and may pose a challenge to the inexperienced radiologist, especially in patients with known extraadrenal malignancies and other comorbidities. It is imperative that radiologists develop the expertise to confidently diagnose adrenal tumors and offer accurate differential considerations, as this will facilitate patient care and obviate need for unnecessary further imaging and intervention.