July 1999, VOLUME 173
NUMBER 1

Recommend & Share

July 1999, Volume 173, Number 1

Characterization of adrenal masses using MR imaging with histopathologic correlation.

Citation: American Journal of Roentgenology. 1999;173: 15-22. 10.2214/ajr.173.1.10397092

ABSTRACT :

The purpose of this study was to evaluate the sensitivity, specificity, and accuracy of MR imaging in the characterization of adrenal masses by correlating imaging findings with histopathologic results. In addition, adrenal tumors that were of an indeterminate nature on MR imaging were analyzed.

For 114 patients with 134 adrenal masses, MR findings were compared with histologic results. In all patients, MR imaging was performed using T2-weighted fast spin-echo imaging and unenhanced and gadolinium-enhanced T1-weighted spin-echo imaging. Chemical-shift imaging was performed in 92 patients and dynamic gadolinium-enhanced studies in 108 patients. Chemical-shift images were analyzed quantitatively and qualitatively, and dynamic gadolinium-enhanced studies were qualitatively assessed.

The sensitivity of MR imaging in differentiating between benign and malignant adrenal masses was 91%, the specificity was 94%, and the accuracy was 93%. The diagnosis at MR imaging differed from that at histology in 12 (9%) of 134 patients. Results of quantitative analyses of chemical-shift imaging techniques showed significant differences between adenomas and nonadenomas (-36.0% versus -3.7%; p < .001). Qualitative analysis provided a similar diagnostic confidence compared with quantitative analysis. Both chemical-shift and dynamic gadolinium-enhanced studies proved to be unreliable in characterizing borderline tumors (epithelial tumors with high malignant potential). Moreover, such imaging failed to allow correct diagnosis of adenomas in two patients.

The characterization of an adrenal mass can be made with high sensitivity and specificity using MR imaging. The increased reliance on MR imaging seems to be based mainly on findings from chemical-shift and dynamic gadolinium-enhanced studies. The need to perform histologic sampling of incidentally discovered adrenal masses may be reduced to some problematic lesions, which will remain during the era of MR imaging.

Recommended Articles

Characterization of adrenal masses using MR imaging with histopathologic correlation.

Full Access, , , , , ,
American Journal of Roentgenology. 1995;164:637-642. 10.2214/ajr.164.3.7863885
Abstract | PDF (1089 KB) | PDF Plus (516 KB) 
Full Access,
American Journal of Roentgenology. 2017;208:1206-1217. 10.2214/AJR.16.17758
Abstract | Full Text | PDF (1411 KB) | PDF Plus (1461 KB) 
Full Access,
American Journal of Roentgenology. 2002;179:559-568. 10.2214/ajr.179.3.1790559
Citation | Full Text | PDF (10513 KB) | PDF Plus (10727 KB) 
Full Access, ,
American Journal of Roentgenology. 2008;190:1163-1168. 10.2214/AJR.07.2799
Abstract | Full Text | PDF (513 KB) | PDF Plus (758 KB) 
Full Access, , , ,
American Journal of Roentgenology. 1995;165:579-583. 10.2214/ajr.165.3.7645474
Abstract | PDF (961 KB) | PDF Plus (532 KB) 
Full Access, , , , , ,
American Journal of Roentgenology. 2019;212:554-561. 10.2214/AJR.18.20097
Abstract | Full Text | PDF (724 KB) | PDF Plus (754 KB) | Supplemental Material