MR imaging of the adrenals: correlation with computed tomography

The purpose of this study was to evaluate the role of magnetic resonance (MR) imaging in adrenal disease based on correlative imaging with CT. Fifty lesions in 36 patients with a variety of adrenal diseases were evaluated, at 0.5 T using spin echo (SE) multislice short repetition time (TR) and SE multislice multiecho long TR sequences. It is concluded that MR is capable of identifying most adrenal abnormalities previously detected by CT. The results suggest that MR has a greater specificity for mass lesions and might be useful to differentiate nonfunctioning adenomas from functioning adenomas, metastasis, pheochromocytomas, cysts, and intraadrenal hemorrhage. Magnetic resonance imaging also has the potential to detect aldosteronomas by increased signal intensity in addition to contour distortion using long TR/echo time sequences. The ability to perform multiplanar imaging and the presence of superior contrast as compared with CT are useful for the assessment of origin and extension of large lesions and the detection of pheochromocytomas in complex cases. Considering MR's limitations, we believe that at present its major role in evaluation of adrenal disease should be complementary to CT.