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Characterization of adrenal masses using MR imaging with histopathologic correlation
G Heinz-Peer1, S Hönigschnabl, B Schneider
1Department of Radiology, the Ludwig Boltzmann Institute for Radiologic Tumor Diagnosis, University of Vienna, Austria.
AJR. American Journal of Roentgenology
|July 9, 1999
Summary
Magnetic resonance (MR) imaging accurately characterizes adrenal masses, showing high sensitivity and specificity. This technique may reduce the need for biopsies of incidentally discovered adrenal tumors, though some borderline lesions require further evaluation.
Area of Science:
- Radiology
- Oncology
- Endocrinology
Background:
- Adrenal masses are common findings, and accurate characterization is crucial for appropriate management.
- Distinguishing between benign and malignant adrenal tumors can be challenging.
- Magnetic resonance (MR) imaging offers advanced techniques for adrenal mass evaluation.
Purpose of the Study:
- To evaluate the sensitivity, specificity, and accuracy of MR imaging in characterizing adrenal masses.
- To correlate MR imaging findings with histopathologic results.
- To analyze adrenal tumors of indeterminate nature on MR imaging.
Main Methods:
- MR imaging was performed on 114 patients with 134 adrenal masses.
- Techniques included T2-weighted fast spin-echo, unenhanced and enhanced T1-weighted spin-echo, chemical-shift imaging, and dynamic gadolinium-enhanced studies.
- Quantitative and qualitative analyses were applied to chemical-shift and dynamic gadolinium-enhanced studies.
Main Results:
- MR imaging demonstrated 91% sensitivity, 94% specificity, and 93% accuracy in differentiating benign from malignant adrenal masses.
- Quantitative chemical-shift imaging showed significant differences between adenomas and nonadenomas (p < .001).
- Chemical-shift and dynamic gadolinium-enhanced studies were unreliable for borderline tumors.
Conclusions:
- MR imaging provides high sensitivity and specificity for adrenal mass characterization.
- Chemical-shift and dynamic gadolinium-enhanced studies are key components of MR imaging for adrenal masses.
- Histologic sampling may be reduced for some incidentally discovered adrenal masses, but problematic lesions still require biopsy.