European Radiology

, Volume 18, Issue 12, pp 2885–2892

Adrenal phaeochromocytoma: correlation of MRI appearances with histology and function

  • Audrey E. T. Jacques
  • Anju Sahdev
  • Madrika Sandrasagara
  • Rick Goldstein
  • Daniel Berney
  • Andrea G. Rockall
  • Shern Chew
  • Rodney H. Reznek
Magnetic Resonance


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 imaging Adrenal gland Phaeochromocytoma 


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Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Audrey E. T. Jacques
    • 1
    • 4
  • Anju Sahdev
    • 1
  • Madrika Sandrasagara
    • 1
  • Rick Goldstein
    • 2
  • Daniel Berney
    • 3
  • Andrea G. Rockall
    • 1
  • Shern Chew
    • 2
  • Rodney H. Reznek
    • 1
  1. 1.Cancer ImagingSt Bartholomew’s HospitalLondonUK
  2. 2.Department of EndocrinologySt Bartholomew’s HospitalLondonUK
  3. 3.Department of HistopathologySt Bartholomew’s HospitalLondonUK
  4. 4.Cancer ImagingLondonUK

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