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Volume 4 No. 1, January 2009 |
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Superiority of CT and MRI in Imaging of Adrenal Masses Eid Al Sayed Abdel Kader(1)& Al Gamal Sameer Abdel Hakeem(2)
Departments of Radiology & Imaging(1) And Urology(2),
Faculty of Medicine, Tanta University, Egypt
Aim: Evaluation of CT as superior imaging modality in some
adrenal lesions as adenoma and the high importance MRI imaging in
malignant adrenal lesions with relation to the surrounding
structures over other modality techniques. Material & Methods: 30
Patients with adrenal lesions are examined by different imaging
techniques as the adrenal gland is a common site of disease, and
detection of adrenal masses has increased with the expanding use of
cross-sectional imaging. CT and MRI are playing a critical role in
not only the detection of adrenal abnormalities but in
characterizing them as benign or malignant. Results: The study
illustrates and describes the appropriate radiologic work-up for
diseases affecting the adrenal gland. The work-up of a suspected
hyper-functioning adrenal mass (pheochromocytoma and aldosteronoma)
which should be start with appropriate biochemical screening tests
followed by thin-collimation computed tomography (CT) and MRI.
Conclusion: If results of CT are not diagnostic, magnetic resonance
(MR) imaging examinations should be performed. CT has can
differentiate a benign adenoma from a metastasis While MRI highly
effective in diagnosing the malignant adrenal masses and its
relation to surrounding structures so , by CT If the attenuation of
the adrenal gland is over 10 HU at non-enhanced CT, contrast
material–enhanced CT should be performed and washout calculated.
Over 50% washout of contrast material on a 10-minute delayed CT scan
is diagnostic of an adenoma while chemical shift MR imaging is also
highly sensitive technique for differentiating adenomas from
metastases to the adrenal gland. When results of CT examinations are
equivocal, MR imaging is the next imaging study of choice for
characterizing adrenal lesions ,our study has shown that MR imaging
more accurate in all equivocal adrenal lesions.
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