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Characterization of Adrenal Tumors by Chemical Shift Fast Low-Angle Shot MR Imaging: Comparison of Four Methods of Quantitative Evaluation

¹ Department of Radiology, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima, 890-8520, Japan.

View larger version (10K): [in a new window]   Fig. 1A. —Scatterplots show differences in four parameters used to differentiate adenomas from metastatic tumors. All parameters are percentages. Signal intensity indexes of adenomas and metastatic tumors show no overlap.

View larger version (10K): [in a new window]   Fig. 1B. —Scatterplots show differences in four parameters used to differentiate adenomas from metastatic tumors. All parameters are percentages. Considerable overlap is seen in adrenal-to-spleen (B), adrenal-to-muscle (C), and adrenal-to-liver (D) ratios of adenomas and metastatic tumors.

View larger version (10K): [in a new window]   Fig. 1C. —Scatterplots show differences in four parameters used to differentiate adenomas from metastatic tumors. All parameters are percentages. Considerable overlap is seen in adrenal-to-spleen (B), adrenal-to-muscle (C), and adrenal-to-liver (D) ratios of adenomas and metastatic tumors.

View larger version (10K): [in a new window]   Fig. 1D. —Scatterplots show differences in four parameters used to differentiate adenomas from metastatic tumors. All parameters are percentages. Considerable overlap is seen in adrenal-to-spleen (B), adrenal-to-muscle (C), and adrenal-to-liver (D) ratios of adenomas and metastatic tumors.

View larger version (16K): [in a new window]   Fig. 2. —Graph shows receiver operating characteristic curves to discriminate adenomas and metastatic tumors using signal intensity index () and adrenal-to-spleen (), adrenal-to-muscle () and adrenal-to-liver (•) ratios. Perfect discrimination is represented by 1.0. Signal intensity index has largest area under curve (Az) and adrenal-to-spleen ratio has second largest Az.

View larger version (137K): [in a new window]   Fig. 3A. —54-year-old woman with nonhyperfunctioning adenoma in right adrenal gland. Transverse in-phase MR image (TR/TE, 133/4.4) reveals right adrenal mass (arrow).

View larger version (157K): [in a new window]   Fig. 3B. —54-year-old woman with nonhyperfunctioning adenoma in right adrenal gland. Transverse opposed-phase MR image (133/2.2) reveals lower signal intensity of mass (arrow) than seen on A. Signal intensity index was 66.9%.

View larger version (124K): [in a new window]   Fig. 4A. —61-year-old woman with aldosterone-producing adenoma in right adrenal gland. Transverse in-phase MR image (TR/TE, 133/4.4) reveals right adrenal mass (arrow).

View larger version (138K): [in a new window]   Fig. 4B. —61-year-old woman with aldosterone-producing adenoma in right adrenal gland. Transverse opposed-phase MR image (133/2.2) reveals lower signal intensity of mass (arrow) than seen on A. Signal intensity index was 78.7%.

View larger version (164K): [in a new window]   Fig. 5A. —66-year-old woman with cortisol-producing adenoma in left adrenal gland. Transverse in-phase MR image (TR/TE, 133/4.4) reveals left adrenal mass (arrow).

View larger version (166K): [in a new window]   Fig. 5B. —66-year-old woman with cortisol-producing adenoma in left adrenal gland. Transverse opposed-phase MR image (133/2.2) reveals lower signal intensity of mass (arrow) than is seen on A. Signal intensity index was 54.8%.

View larger version (138K): [in a new window]   Fig. 6A. —68-year-old man with right adrenal metastatic tumor from lung cancer. Transverse in-phase MR image (TR/TE, 133/4.4) reveals right adrenal mass (arrow).

View larger version (143K): [in a new window]   Fig. 6B. —68-year-old man with right adrenal metastatic tumor from lung cancer. Signal cancellation of mass (arrow) on opposed-phase MR image is obscure compared with that seen on A. Signal intensity index was –4.6%.

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