Abstract
The detection of incidental adrenal masses has increased substantially with the advent and widespread use of highresolution cross-sectional imaging techniques such as CT and MRI. The work-up and treatment of these incidentally found adrenal masses continue to be a clinical challenge for radiologists, endocrinologists, and adrenal surgeons. The approach to the evaluation of most of these adrenal masses depends on the radiologic appearance of the lesion, and whether the patient has a known underlying malignancy. The aim of this article is to review imaging features of pathologic abnormalities of the adrenal gland. Recent advances in noninvasive imaging methods that attempt to differentiate benign from malignant lesions also are addressed.
Similar content being viewed by others
References and Recommended Reading
Korobkin MT, Brodeur FJ, Kloos RT, et al.: The incidental adrenal mass. Radiol Clin N Am 2002, 34:1037–1034.
Francis IR, Gross MD, Shapiro B, et al.: Integrated imaging of adrenal disease. Radiology 2001, 184:1–13.
Cheema P, Cartegena R, Staubitz W: Adrenal cysts: diagnosis and treatment. J Urol 1981, 126:396–399.
Dunnick NR: Adrenal imaging: current status. AJR Am J Roentgenol 1990, 154:927–936.
Rozenblit A, Morehouse HT, Amis SE: Cystic adrenal lesions: CT features. Radiology 1996, 201:541–548.
Korobkin M, Francis IR: Adrenal imaging. Semin Ultrasound CT MR 1995, 16:317–330. This review provides an excellent overview of imaging features of various pathologic conditions of the adrenal gland.
Cyran KM, Kenney PJ, Memel DS, et al.: Adrenal myelolipoma. AJR Am J Roentgenol 1996, 166:395–400.
Rao P, Kenney PJ, Wagner BJ, et al.: Imaging and pathologic features of myelolipoma. Radiographics 1997, 17:1373–1385.
Hedeland H, Ostberg G, Hokfelt B: On the prevalence of adrenocortical adenomas in an autopsy material in relation to hypertension and diabetes. Acta Med Scand 1968, 184:211–214.
Aso Y, Homma Y: A survey of incidental adrenal tumors in Japan. J Urol 1992, 147:1487–1481.
Korobkin M, Giordano TJ, Brodeur FJ, et al.: Adrenal adenomas: relationship between histologic lipid and CT and MR findings. Radiology 1996, 200:743–747.
Korobkin M, Brodeur FJ, Yutzy G, et al.: Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. AJR Am J Roentgenol 1996, 166:531–536.
Korobkin M, Brodeur FJ, Francis IR, et al.: CT timeattenuation washout curves of adrenal adenomas and nonadenomas. AJR Am J Roentgenol 1998, 170:747–752. This study provides a detailed description of the technique and results of CT enhancement washout to differentiate adenomas from nonadenomas.
Dunnick NR, Korobkin M, Francis I: Adrenal radiology: distinguishing benign from maligant adrenal masses. AJR Am J Roentgenol 1996, 167:861–867.
Outwater EK, Siegelman ES, Radecki PD, et al.: Distinction between benign and malignant adrenal masses: value of T1-weighted chemical-shift MR imaging. AJR Am J Roentgenol 1995, 165:579–583. This study provides a detailed description of the technique and results of chemical-shift MRI to differentiate adenomas from nonadenomas.
Fishman EK, Deutch BM, Hartman DS, et al.: Primary adrenocortical carcinoma: CT evaluation with clinical correlation. AJR Am J Roentgenol 1987, 148:531–535.
Dunnick NR, Heaston D, Halvorsen R, et al.: CT appearance of adrenocortical carcinoma. J Comput Assist Tomogr 1982, 6:978–982.
Schlund JF, Kenney PJ, Brown ED, et al.: Adrenocortical carcinoma: MR imaging appearance with current techniques. J Magn Reson Imaging 1995, 5:171–174.
Paling MR, Williamson BR: Adrenal involvement in non-Hodgkin lymphoma. J Magn Reson Imaging 1983, 141:303–305.
Abrams HL, Spiro R, Goldstein N: Metastases in carcinoma: analysis of 1000 autopsied cases. Cancer 1950, 3:74–85.
Lee MJ, Hahn PF, Papanicolaou N, et al.: Benign and malignant adrenal masses: CT distinction with attenuation coef.cients, size and observer analysis. Radiology 1991, 179:415–418.
Szolar DH, Kammerhuber F: Quantitative CT evaluation of adrenal gland masses: a step forward in the differentiation between adenomas and nonadenomas. Radiology 1997, 202:517–521.
Boland G, Hahn PF, Pena C, et al.: Adrenal masses: characterization with delayed contrast-enhanced CT. Radiology 1997, 202:693–696.
Korobkin M, Lombardi TJ, Aisen AM, et al.: Characterization of adrenal masses with chemical shift and gadolinium-enhanced MR imaging. Radiology 1995, 197:411–418.
Zornoza J, Bracken R, Wallace S: Radiographic features of adrenal metastases. Urology 1976, 179:415–418.
Gross MD, Shapiro B, Francis IR, et al.: Scintigraphic evaluation of clinically silent adrenal masses. J Nucl Med 1994, 35:1145–1152.
Wilson DA, Muchmore HG, Tisdal RG, et al.: Histoplasmosis of the adrenal gland studied by CT. Radiology 1984, 150:779–783.
Berliner L, Bosniak MA, Megibow AJ: Adrenal pseudotumors on computed tomography. J Comput Assist Tomogr 1982, 6:281–285.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Del Pizzo, J.J. Radiographic evaluation of the incidental adrenal lesion. Curr Urol Rep 7, 69–72 (2006). https://doi.org/10.1007/s11934-006-0044-7
Issue Date:
DOI: https://doi.org/10.1007/s11934-006-0044-7