Adrenal tumors

Raumforderung

der Nebenniere links in der MRT mit deutlichen Signalverlust in der T1 Opposed-Phase rechts gegenüber In-Phase links, sodass der Befund gut mit einem Nebennierenadenom vereinbar ist.

An der linken

Nebenniere finden sich zwei Raumforderungen, von denen die weiter dorsal gelegene einen deutlichen Fettanteil enthält, wie man aus dem Signalabfall in der T1 out of phase sehen kann. Die andere ist ohne typischen Signalabfall verdächtig für eine Metastase oder ein primäres Malignom der Nebenniere. Links oben T1 in phase, unten T1 out of phase (oder opposed phase). Rechts oben T2, unten T1 FS KM.

Adrenal gland

tumors • Neuroblastoma - Ganzer Fall bei Radiopaedia

Adrenal gland

tumors • Pheochromocytoma - Ganzer Fall bei Radiopaedia

Imaging

features of adrenal masses. Right adrenal hemorrhage in a 61-year-old man with acute abdominal pain after starting anticoagulant therapy. Axial unenhanced (a) and arterial (b) phase CT images show a large right adrenal hematoma (arrow) with relatively high attenuation values and without enhancement after contrast injection

Myelolipom

der linken Nebenniere (Pfeile). Die Pfeilspitze zeigt auf die normale rechte Nebenniere.

Myelolipom

der linken Nebenniere in der Computertomographie axial.

Myelolipoma

of right adrenal gland in Computertomography.

Imaging

features of adrenal masses. Right cortical carcinoma in a 70-year-old woman admitted to the emergency department for atraumatic abdominal pain. US (a) shows a large heterogeneous right adrenal mass (arrow). Axial T2-weighted spin echo (b), three-dimensional fat-suppressed T1-weighted gradient recalled echo images before contrast injection (c), in arterial phase (d) images confirm the presence of a large right adrenal mass with necrotic and hemorrhagic components which present as areas of high signal on unenhanced T1-weighted (c) images and non-enhancing areas after contrast injection (d)

Imaging

features of adrenal masses. Adrenal adenoma of a 45-year-old woman. Unenhanced CT (a) shows a left adrenal mass (arrow) with lower attenuation values than 10 HU. Axial T1-weighted in-phase (b) and out-of-phase (c) gradient recalled echo MR images show prominent loss of signal on out-of-phase

Imaging

features of adrenal masses. Bilateral adrenal hyperplasia in a 75-year-old woman. Axial T1-weighted in-phase (a) and out-of-phase gradient recalled echo (c), T2-weighted fast spin echo (c), and three dimensional fat-suppressed T1-weighted gradient recalled echo image in portal phase after contrast injection (d) show the nodular enlargement of both adrenal glands (arrows) with loss of signal on out-of-phase (b)

Imaging

features of adrenal masses. Right adrenal cyst in a 50-year-old woman. Axial T2-weighted fat-saturated fast spin echo MR image (a), three-dimensional fat-suppressed T1-weighted gradient recalled echo images before (b) and after paramagnetic contrast administration (c) show a right adrenal cystic lesion (arrow) with low T1 signal intensity, high T2 signal intensity, no contrast enhancement and no septations, blood products, soft-tissue components, or calcifications

Adenom der

rechten Nebenniere - in phase (oben) und out of phase (unten). Die rechte Nebenniere zwischen Leber und Wirbelsäule zeigt eine ovaläre Raumforderung, die in der T1-in-phase intermediär in der T1-out-of-phase deutlich signalärmer zur Darstellung kommt. Links ist der Oberpol der Niere angeschnitten.

Imaging

features of adrenal masses. Left adrenal myelolipoma incidentally discovered in a lumbar CT scan on a 51-year-old man. Unenhanced CT (a) shows a left adrenal mass with macroscopic fat (arrowhead) and a soft-tissue myeloid component (arrow). Axial T2-weighted fast spin echo (b), T2-weighted fat-saturated spin echo (c), T1-weighted in-phase (d), and out-of-phase gradient recalled echo images (e) show the signal drop of macroscopic fat in fat-suppressed T2-weigthed images (c, arrowhead) and show loss of signal on out-of-phase imaging of the myeloid element (e, arrow)

Imaging

features of adrenal masses. Bilateral adrenal pheochromocytoma in a 27-year-old woman with multiple endocrine neoplasia type 2. Axial T2-weighted fat-saturated spin echo (a), three-dimensional fat-suppressed T1-weighted gradient recalled echo images before contrast injection (b), and in portal phase (c) images show a bilateral adrenal mass with high T2 signal intensity and strong and heterogenous contrast enhancement. The signal intensity is typically more inhomogenous in larger lesions (white arrow, right adrenal gland) than in smaller ones (black arrow, left adrenal gland)

Imaging

features of adrenal masses. Right adrenal hemangioma in a 49-year-old woman. Coronal reformatted CT images before (a) and after contrast injection in arterial (b) and late phase (c) show a well-encapsulated large right adrenal lesion (arrow) showing peripheral contrast enhancement with progressive centripetal filling and a hypodense center

Imaging

features of adrenal masses. Left adrenal lymphomatous lesion in a 70-year-old man with non-Hodgkin lymphoma. Coronal reformatted CT images before (a) and after contrast injection in portal phase (b) show a large left adrenal mass (arrow) with inhomogeneous enhancement. Axial CT image of the lower abdomen in portal phase (c; arrow) shows the gastrointestinal involvement by lymphoma as aneurysmal dilatation of some loops of the small bowel

Imaging

features of adrenal masses. Left adrenal metastasis in a 62-year-old woman with lung cancer. Unenhanced CT (a), portal (b), and late phase (c) images show a left adrenal mass (arrow) with attenuation value of 26 HU on unenhanced CT (a) and “absolute percentage washout” of 15%. Staging 18F-FDG PET/CT (d) performed 3 months later revealed a left adrenal lesion (arrow) with high metabolic activity (SUVmax 14 g/mL) and increased in size in comparison with CT images. After chemotherapy, restaging 18F-FDG-PET/CT (e) showed morpho-functional disease progression of the adrenal lesion (arrow) with signs of central necrosis (SUVmax 19 g/mL with central necrotic area of absence of 18F-FDG uptake). Images of 18F-FDG-PET/CT provided by database of Nuclear Medicine Service, Fondazione Istituto G. Giglio, Cefalù, Italy

Imaging

features of adrenal masses. Left adrenal metastasis in a 58-year-old woman with breast cancer. Axial unenhanced CT (a), portal phase (b), T2-weighted fast spin echo (c), b800 s/mm2 diffusion-weighted image (d), ADC map (e), and coronal three-dimensional fat-suppressed T1-weighted gradient recalled echo image in portal phase after contrast injection (f) show a left adrenal mass (arrow). This lesion intra-lesional hemorrhage presenting as spontaneously hyperdense area on unenhanced CT (a), hypointense on T2-weighted (c), and no enhancement on CT (b) and MR (f) images after contrast injection. The peripheral solid component of the lesion shows also restricted pattern of diffusion (d, e)

Adrenal gland

tumors • Right adrenal sarcoma - Ganzer Fall bei Radiopaedia