MRI of indeterminate adrenal masses

The histologic type of adrenal tumors can be accurately predicted by MRI on the basis of their signal intensity on a T2-weighted image. However, a small but significant number of nonfunctioning adenomas, carcinomas, and metastases cannot be differentiated because they have similar signal intensities on a spin-echo 2500/80 scan. Eight (21%) of 38 of these tumors fell into this group. Differentiation between incidental adenomas and metastases can be conclusively achieved only when the primary neoplasm can also be imaged and displays high signal intensity on T2-weighted images.