Adrenal tissue characterization using MR imaging.

Glazer, G M; Woolsey, E J; Borrello, Joseph A.; Francis, I R; Aisen, AM; Bookstein, Fred L.; Amendola, MA; Gross, Milton D.; Bree, Robert L.; Martel, William

doi:10.1148/radiology.158.1.3940402

Cited by 161 publications

(30 citation statements)

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“…Except for our observation, there is no M R description of adrenal l e i o m y o m a in the literature, as far as we know. The absence of obvious hyperintensity on T2-weighted images allowed us to eliminate a p h e o c h r o m o c y t o m a and the central attenuation zone was against an adenoma [8].…”

Section: Discussionmentioning

confidence: 99%

Leiomyoma of the adrenal gland in a patient with AIDS

et al. 1994

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Leiomyoma of the adrenal gland is an exceptional localization. We report a case occurring in a young patient with AIDS. Diagnosis was a surprise on pathologic examination. On enhanced computed tomographic (CT) scan, the adrenal mass had a low central attenuation area and a thin enhancing peripheral ring. On magnetic resonance (MR) imaging the left adrenal mass was isointense with the liver on T1-(TR/TE = 500/300 ms) and T2-(TR/TE = 2030/60, 120 ms) weighted spin-echo images, except a central area with a lower signal on T1-weighted images and a higher signal on T2-weighted images. The mass was slightly enhanced after Gd-DOTA injection, but the central area remained unchanged.

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Section: Discussionmentioning

confidence: 99%

Leiomyoma of the adrenal gland in a patient with AIDS

et al. 1994

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“…On T2-weighted images all phaeochromocytomas show a very high signal intensity relative to the liver (Fig. 5) [81,82]. This feature is known to be shared by other truncal paragangliomas [11,83,84].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 89%

Magnetic resonance imaging or metaiodobenzylguanidine scintigraphy for the demonstration of paragangliomas?

et al. 1994

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Paragangliomas are tumours arising from paraganglionic tissue dispersed from the base of the skull to the pelvic diaphragm. These tumours produce symptoms by secreting catecholamines (functioning tumours) or by local tumour expansion. They can be part of several hereditary disorders. The introduction of magnetic resonance (MR) imaging and metaiodobenzylguanidine (MIBG) scintigraphy has provided new insights into paragangliomas and has tremendously changed the topographic diagnosis of paragangliomas. Both techniques have proven to be adequate in localising paragangliomas. In this report, the performance of these two noninvasive imaging methods in the examination of paragangliomas is compared and the merits and deficits of the two techniques are discussed. Both techniques produce comparable results in the detection of functioning paragangliomas. MR imaging, however, also demonstrates tumours that do not take up MIBG. MR imaging does not involve the use of ionising radiation and is not hampered by medication. Moreover, MR imaging has a higher spatial resolution. Because of these merits it is concluded that for demonstration of paragangliomas, wholebody MR imaging is the preferred and initial method of investigation. MIBG scintigraphy, on the other hand, continues to be a reliable method for non-invasive detection of functioning paragangliomas. At present it is clearly faster in whole-body imaging than MRI and it is definitely patient-friendly (no claustrophobia). It could be reserved for cases where a strong suspicion of a functioning paraganglioma persists, despite normal MR imaging findings, and for cases where doubt exists about the functional activity of one or more multicentric tumours. MIBG scintigraphy must be used in the evaluation of patients referred for iodine-131 MIBG treatment.

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“…On magnetic resonance imaging (MRI), malignancies usually show high signal intensity on T2-weighted images, whereas most benign tumors have isointense or low signal intensity on both T1-and T2-weighted images. Approximately 30% of masses cannot be distinguished reliably on T2-weighted images (40). Both CT and MRI are accurate in assessing tumor spread into tissues such as the liver, lymph nodes, lung and inferior vena cava.…”

Section: Imaging Studiesmentioning

confidence: 99%

A comprehensive approach to adrenal incidentalomas

Mantero

Albiger

2004

Arq Bras Endocrinol Metab

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Improvements in abdominal imaging techniques have increased the detection of clinically inapparent adrenal masses, or incidentalomas (AI), the appropriate diagnosis and management of which have become a common clinical problem for health care professionals. Once an adrenal mass has been detected, the clinician needs to address two questions: 1) is the tumor hormonally active? and 2) is there any chance of the mass being malignant? The majority of AI is nonhypersecretory cortical adenomas, but an endocrine evaluation can lead to the identification of subtle hormone excess. An overnight lowdose dexamethasone suppression test, fractionated urinary or plasma metanephrine assay and, in hypertensive patients, establishing the upright plasma aldosterone/plasma renin activity ratio are recommended as preliminary screening steps. Masses greater than 4cm are at greater risk of malignancy. Morphological imaging features may be helpful in the distinction between benign and malignant forms. Fine-needle aspiration biopsy is an important tool in the evaluation of oncological patients to establish any metastatic disease. Adrenalectomy is indicated by evidence of a functional adrenal mass, or a suspected malignant form. We advocate adrenalectomy of subtle hypercortisolism, especially in the presence of hypertension, obesity, diabetes or osteoporosis potentially aggravated by glucocorticoid excess. A close followup is needed, particularly in the first year after diagnosis. O aperfeiçoamento das técnicas de imagem abdominal tem aumentado a detecção de massas adrenais clinicamente não aparentes, ou incidentalomas (IA), cujo diagnóstico e manuseio apropriados têm se tornado um problema clínico comum para os profissionais da saúde. Uma vez detectada uma massa adrenal, o clínico é obrigado a formular duas questões: 1) o tumor é hormonalmente ativo? e 2) existe alguma possibilidade de a massa ser maligna?. A maioria dos IA são adenomas corticais não hipersecretores, mas uma avaliação endócrina pode resultar na identificação de um excesso hormonal sutil. Como passos preliminares de screening são recomendados um teste de supressão overnight com doses baixas de dexametasona, a dosagem de metanefrinas em urina fracionada ou no plasma e, em pacientes hipertensos, estabelecer a relação da aldosterona plasmática/atividade plasmática de renina na posição ortostática. Massas maiores que 4cm têm risco maior de malignidade. Achados morfológicos de imagem podem ser valiosos na distinção entre formas benignas e malignas. A biópsia de aspiração com agulha fina é um procedimento importante na avaliação de pacientes oncológicos para se estabelecer qualquer doença metastática. Adrenalectomia está indicada na evidência de uma massa adrenal funcionante, ou na suspeita de atualização A Comprehensive Approach to Adrenal Incidentalomas

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Adrenal tissue characterization using MR imaging.

Cited by 161 publications

References 0 publications

Leiomyoma of the adrenal gland in a patient with AIDS

Leiomyoma of the adrenal gland in a patient with AIDS

Magnetic resonance imaging or metaiodobenzylguanidine scintigraphy for the demonstration of paragangliomas?

A comprehensive approach to adrenal incidentalomas

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