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Comparison of Unenhanced CT and Chemical Shift MRI in Evaluating Lipid-Rich Adrenal Adenomas

Gary M. Israel1, Melvyn Korobkin2, Chun Wang1, Elizabeth N. Hecht1 and Glenn A. Krinsky1

1 Department of Radiology, NYU Medical Center, 560 First Ave., Ste. HW 202, New York, NY 10016.
2 Department of Radiology, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109-0030.



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  		Fig. 1. —Graph shows correlation of unenhanced CT attenuation and adrenal-to-spleen chemical shift ratio. Dotted lines denote threshold values.

 


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  		Fig. 2. —Graph shows correlation of unenhanced CT attenuation and signal-intensity index. Dotted lines denote threshold values.

 


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  		Fig. 3A. —84-year-old man with adrenal adenoma that was characterized using chemical shift MRI but not with unenhanced CT. Unenhanced axial CT image shows 1.5-cm left adrenal mass (arrow), which measures 20 H.

 


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  		Fig. 3B. —84-year-old man with adrenal adenoma that was characterized using chemical shift MRI but not with unenhanced CT. Axial in-phase MR image shows that adrenal mass is slightly hyperintense with respect to spleen.

 


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  		Fig. 3C. —84-year-old man with adrenal adenoma that was characterized using chemical shift MRI but not with unenhanced CT. Axial opposed-phase MR image shows that mass is isointense–hypointense with respect to spleen. For this lesion, adrenal-to-spleen chemical shift ratio and signal-intensity index were 0.32 and 68%, respectively. Qualitative analysis identified signal loss on opposed-phase image. This mass has been stable for 5 years and is consistent with lipid-rich adrenal adenoma.

 

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