MRI of the Adrenal Glands

Kathy Wilber1, Richard Semelka1, Laurie Fisher2

1 University of North Carolina, Chapel Hill, North Carolina, 2 Siemens Uptime Service Center, Cary, North Carolina
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A17.1
DOI:  10.1002/0471142719.mia1701s00
Online Posting Date:  May, 2001
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Abstract

MRI is an effective method to evaluate adrenal pathology. This unit presents a protocol incorporating various types of T1‐ and T2‐weighted sequences, including the use of in‐phase and out‐of‐phase gradient echo techniques and the routine use of intravenous gadolinium.

     
 
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Table of Contents

  • Basic Protocol 1: Adrenal Imaging
  • Commentary
  • Figures
  • Tables
     
 
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Materials

Basic Protocol 1: Adrenal Imaging

  Materials
  • Normal saline (0.9% NaCl), sterile, 40 ml minimum
  • Extravascular contrast agent (e.g., Magnevist, Omniscan, or Prohance), volume is prescribed by patient weight
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Figures

  •   FigureFigure a1.70.1 Unenhanced fat suppressed transverse spoiled gradient echo image.
  •   FigureFigure a1.70.2 Out‐of‐phase transverse spoiled gradient echo image.
  •   FigureFigure a1.70.3 Immediate post contrast transverse spoiled gradient echo image.
  •   FigureFigure a1.70.4 One‐minute post gadolinium spoiled gradient echo transverse image.
  •   FigureFigure a1.70.5 Post‐contrast fat suppressed transverse spoiled gradient echo image.

Videos

Literature Cited

Literature Cited
   Bilbey, J.H., McLoughlin, R.F., Kurkjian, P.S., Wilkins, G.E.L., Chan, N.H.L., Schmidt, N., and Singer, J. 1995. MR imaging of adrenal masses: Value of chemical‐shift imaging for distinguishing adenoma from other tumors. Am. J. Roentgenol. 164:637‐642.
   Korobkin, M., Lombardi, T.J., Aisen, A.M., Francis, I.R., Quint, L.E., and Dunnick, N.R. 1995. Characterization of adrenal masses with chemical shift and gadolinium‐enhanced MR imaging. Radiology 197:411‐418.
   Korobkin, M., Giordano, T.J., Brodeur, F.J., Francis, I.R., Siegelman, E.S., Quint, L.E., Dunnick, N.R., Heiken, J.P., and Wang, H.H. 1996. Adrenal adenomas: Relationship between histologic lipid and CT and MR findings. Radiology 200:743‐747.
   Lee, M.J., Mayo‐Smith, W.M., Hahn, P.F., Goldberg, M.A., Boland, G.W., Saini, S., and Papanicolaou, N. 1994. State‐of‐the‐art MR imaging of the adrenal gland. RadioGraphics 14:1015‐1029.
   Mayo‐Smith, W.W., Lee, M.J., McNicholas, M.M.J., Hahn, P.F., Boland, G.W., and Saini, S. 1995. Characterization of adrenal masses (<5 cm) by use of chemical shift MR imaging: Observer performance versus quantitative measures. Am. J. Roentgenol. 165:91‐95.
   McNicholas, M.M.J., Lee, M.J., Mayo‐Smith, W.W., Hahn, P.F., Boland, G.W., and Mueller, P. 1995. An imaging algorithm for the differential diagnosis of adrenal adenomas and metastases. Am. J. Roentgenol. 165:1453‐1459.
   Mitchell, D.G., Grovello, M., Matteucci, T., Peterson, R.O., and Miettinen, M.M. 1992. Benign adenocortical masses: Diagnosis with chemical shift MR imaging. Radiology 185:345‐351.
   Outwater, E.K., Siegelman, E.S., Radecki, P.D., Piccoli, C.W., and Mitchell, D.G. 1995. Distinction between benign and malignant adrenal masses: Value of T1‐weighted chemical‐shift MR imaging. Am. J. Roentgenol. 165:579‐583.
   Outwater, E.K., Siegelman, E.S., Huang, A.B., and Birnbaum, B.A. 1996. Adrenal masses: Correlation between CT attenuation value and chemical shift ratio at MR imaging with in‐phase and opposed‐phase sequences. Radiology 200:749‐752.
   Reinig, J.W., Stutley, J.E., Leonhardt, C.M., Spicer, K.M., Margolis, M., and Caldwell, C.B. 1994. Differentiation of adrenal masses with MR imaging: Comparison of techniques. Radiology 192:41‐46.
   Shellock, F.G. and Kanal, E. 1996. Magnetic Resonance: Bioeffects, Safety, and Patient Management. Lippincott, Williams & Wilkins, Philadelphia.
   Tsushima, Y., Ishizaka, H., and Matsumoto, M. 1993. Adrenal masses: Differentiation with chemical shift, fast low‐angle shot MR imaging. Radiology 186:705‐709.
Key References
   Shellock and Kanal, 1996. See above.
  Covers a number of important patient management issues related to MR imaging, including recommended safety procedures, a list of metallic implants that have been tested for MR compatibility, and a list of other sources on MR safety.
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