European Radiology

, Volume 18, Issue 12, pp 2885–2892

Adrenal phaeochromocytoma: correlation of MRI appearances with histology and function


    • Cancer ImagingSt Bartholomew’s Hospital
    • Cancer Imaging
  • Anju Sahdev
    • Cancer ImagingSt Bartholomew’s Hospital
  • Madrika Sandrasagara
    • Cancer ImagingSt Bartholomew’s Hospital
  • Rick Goldstein
    • Department of EndocrinologySt Bartholomew’s Hospital
  • Daniel Berney
    • Department of HistopathologySt Bartholomew’s Hospital
  • Andrea G. Rockall
    • Cancer ImagingSt Bartholomew’s Hospital
  • Shern Chew
    • Department of EndocrinologySt Bartholomew’s Hospital
  • Rodney H. Reznek
    • Cancer ImagingSt Bartholomew’s Hospital
Magnetic Resonance

DOI: 10.1007/s00330-008-1073-z

Cite this article as:
Jacques, A.E.T., Sahdev, A., Sandrasagara, M. et al. Eur Radiol (2008) 18: 2885. doi:10.1007/s00330-008-1073-z


The purpose of this study was to describe the range of appearances of adrenal phaeochromocytomas on T2-weighted MRI, correlate appearances with histopathology, and quantify the incidence of the previously described hyperintense appearance. The appearance and MR characteristics of 44 phaeochromocytomas were reviewed retrospectively. T2-weighted appearances were grouped: (1) ‘classical’, homogeneous, high signal intensity, isointense to CSF; (2) homogeneous, isointense or minimally hyperintense to spleen, hypointense to CSF; (3) heterogeneous, marbled appearance; (4) heterogeneous, multiple high signal intensity pockets. All 44 adrenal phaeochromocytomas were well circumscribed, 1.2–15 cm in maximum diameter, with no visual or quantitative signal loss on chemical shift imaging. On T2-weighted MRI 5/44 (11%) had group 1 appearance; 15/44 (34%) group 2, 7/44 (16%) group 3; and 17/44 (39%) group 4. Homogeneous group 1 and 2 lesions were smaller (mean 4.5 cm) than heterogeneous group 3 and 4 lesions (mean 6.3 cm). Increasing MRI heterogeneity correlated pathologically with increasing amounts of haemorrhage, necrosis and fibrosis. No MRI features were predictive of malignancy. Non-functioning phaeochromocytomas were larger than functioning lesions. No size difference was seen between syndrome and sporadic lesions. In this large series we report a wide range of appearances of adrenal phaeochromocytomas on T2-weighted MRI. The previously described classical hyperintense phaeochromocytoma is relatively uncommon.


Magnetic resonance imagingAdrenal glandPhaeochromocytoma

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© European Society of Radiology 2008