Computertomographie und Magnetresonanztomographie in der Differentialdiagnose von Nebennierenraumforderungen

Abstract

Adrenal gland tumors are often incidental findings during imaging of the upper abdomen. In the majority of cases, benign adrenal gland tumors, especially nonfunctioning adenomas, are diagnosed, although the evaluation of dignity is essential in order to avoid unnecessary biopsy and tumor extirpation. Lipid-containing adrenocortical adenomas and nonadenomas can be differentiated with high diagnostic accuracy and specificity by computed tomography (CT) and magnetic resonance imaging (MRI). The fat content of these lesions can be correlated with CT attenuation values or with signal decrease in chemical shift imaging in MRI. Furthermore, low-fat adenomas can be distinguished from nonadenomas with delayed contrast enhancement and washout characterization. For the differentiation of non-fat-containing nonadenomas (metastases, lymphoma, pheochromocytoma, and inflammatory processes), morphological imaging criteria in CT and MRI (signal alterations, contrast media enhancement), clinical signs and laboratory test are essential in order to establish the diagnosis. The localization of functioning adenomas can be easily performed with CT and MRI. Both imaging techniques reveal typical findings of lesions-like cysts and myelolipomas.

Optimized in-phase and opposed-phase MR imaging for accurate detection of small fat or water fractions: theoretical considerations and experimental application in emulsions

“…c-f Fat/water content maps of the phantoms resulting from the IP and OP images processed according to Eqs. (5)- (7). Small fat fractions imaged at c α E,fat + 25% by the 2D and d α E,fat by the 3D IP/OP-method.…”

“…For example, MR detection of a small amount of water within regions containing mostly fat can be helpful in diagnosis and treatment monitoring in cases with infectious cellulite in subcutaneous tissue [1] or lymphedematous subcutis [2]. The measurement of small fat fractions within water rich tissue can be performed to obtain muscle fiber type composition [3][4][5], to characterize neuromuscular diseases [6], to assess the malignancy of focal lesions inside the liver or the adrenal gland [7,8], or to detect nonalcoholic fatty liver disease, which correlates with the risk to develop type 2 diabetes [9]. Diseases of the red bone marrow such as leukemia, aplastic anemia, or multiple myeloma and their response to cytotoxic treatment can be detected by reliable assessment of the fat fraction as well [10][11][12].…”

Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review)

“…5. If the nature of the lesion is questionable, after 3-4 months of dynamic observation, it is necessary to repeat and expand the diagnostic search [14, 18].…”

Primary hyperaldosteronism presenting as recurrent polymorphic ventricular tachycardia (RCDD code: VI-2)

“…Plasma aldosterone level was 1822 pg/mL (reference range: 30-160 pg/mL) and renin activity was <0.01 pg/mL (reference value: <17.22 pg/mL). Abdominal computed tomography (CT) scan revealed a left adrenal mass (Figure 3) measuring 34x20 mm with a density of −28 Hounsfield units, consistent with a lipid-rich adenoma [10].…”