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MRI of the Adrenal Glands

Kathy Wilber¹, Richard Semelka¹, Laurie Fisher²

¹University of North Carolina, Chapel Hill, North Carolina
²Siemens 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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Unit Introduction
Basic Protocol: Adrenal Imaging
Commentary
Bibliography
Figures
Tables

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Materials

Basic Protocol: 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

Figure A17.1.1

Unenhanced fat suppressed transverse spoiled gradient echo image.

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Figure A17.1.2

Out-of-phase transverse spoiled gradient echo image.

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Figure A17.1.3

Immediate post contrast transverse spoiled gradient echo image.

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Figure A17.1.4

One-minute post gadolinium spoiled gradient echo transverse image.

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Figure A17.1.5

Post-contrast fat suppressed transverse spoiled gradient echo image.

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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.