Imaging of adrenal masses

Area of Science:

• Radiology
• Endocrinology
• Pathology

Background:

• Adrenal pathology classification involves hormonal function, imaging findings, and pathological diagnosis.
• Hyperfunctional states (Conn's, Cushing's), hypofunctional states (Addison's), and incidentally discovered lesions represent key categories.
• Imaging plays a crucial role in characterizing adrenal lesions, guiding further management.

Purpose of the Study:

• To review the diagnostic approaches to adrenal pathology.
• To highlight the role of various imaging modalities in characterizing adrenal lesions.
• To discuss the indications and limitations of biopsy in adrenal pathology.

Main Methods:

• Review of common imaging modalities for adrenal pathology: non-enhanced CT, contrast CT, and chemical shift MRI.
• Discussion of characteristic imaging appearances of specific adrenal lesions.
• Evaluation of the utility and risks of fine needle aspiration and core biopsies.

Main Results:

• Adrenal adenomas often appear as well-defined, low-density lesions on CT, characterized by contrast washout or MRI signal changes.
• Specific lesions like pheochromocytoma, myelolipoma, and adrenal cysts have characteristic imaging appearances.
• Non-specific findings may necessitate biopsy, despite associated risks like infection and hemorrhage.

Conclusions:

• Imaging, particularly CT and MRI, is often sufficient for diagnosing common adrenal lesions.
• Biopsy is reserved for cases where non-invasive imaging is inconclusive.
• A thorough understanding of imaging characteristics aids in appropriate patient management and avoids unnecessary invasive procedures.