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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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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Basic Protocol 1: Adrenal Imaging

  • 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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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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