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Adrenal phaeochromocytoma: correlation of MRI appearances with histology and function

  • Magnetic Resonance
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Abstract

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.

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Authors and Affiliations

  1. Cancer Imaging, St Bartholomew’s Hospital, West Smithfield, London, EC1A 7BE, UK

    Audrey E. T. Jacques, Anju Sahdev, Madrika Sandrasagara, Andrea G. Rockall & Rodney H. Reznek

  2. Department of Endocrinology, St Bartholomew’s Hospital, West Smithfield, London, EC1A 7BE, UK

    Rick Goldstein & Shern Chew

  3. Department of Histopathology, St Bartholomew’s Hospital, West Smithfield, London, EC1A 7BE, UK

    Daniel Berney

  4. Cancer Imaging, Dominion House, 59 Bartholomew Close, London, EC1A 7ED, UK

    Audrey E. T. Jacques

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  1. Audrey E. T. Jacques
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Correspondence to Audrey E. T. Jacques.

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Jacques, A.E.T., Sahdev, A., Sandrasagara, M. et al. Adrenal phaeochromocytoma: correlation of MRI appearances with histology and function. Eur Radiol 18, 2885–2892 (2008). https://doi.org/10.1007/s00330-008-1073-z

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  • DOI: https://doi.org/10.1007/s00330-008-1073-z

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