Adrenocortical carcinoma MRI: Difference between revisions

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Revision as of 14:40, 20 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

MRI scans are helpful in differentiating between adrenal adenoma, carcinoma, and metastatic lesions.

Adrenocortical carcinomas are usually large and appear as heterogeneous masses on both T1- and T2-weighted images owing to the presence of internal hemorrhage and necrosis.
Adrenocortical carcinoma can contain foci of intracytoplasmic lipid, which results in a loss of signal intensity on out-of-phase images.
Large adrenal carcinomas tend to invade the adrenal vein and inferior vena cava.

On MRI, ACCs appear isointense to hypointense relative to liver parenchyma on T1-weighted images and hyperintense relative to liver parenchyma on T2-weighted images(98).

On chemical-shift MRI, the presence of intracellular lipid can cause regions of signal loss on out-of-phase images relative to inphase images (98).

Inferior vena cava invasion has been reported in 9% to 19% of cases at presentation (98). Due to the multiplanar capability of MRI, direct invasion of adjacent organs may be better shown.

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 ==MRI Findings in adrenocortical carcinoma==
 * Adrenocortical carcinomas are usually large and appear as heterogeneous masses on both T1- and T2-weighted images owing to the presence of internal hemorrhage and necrosis.
-* Adrenocortical carcinoma can contain foci of intracytoplasmic lipid, which results in a loss of signal intensity on out-of-phase images.
+* Adrenocortical carcinoma can contain foci of intra[[cytoplasmic]] [[lipid]], which results in a loss of signal intensity on out-of-phase images.
-* Large adrenal carcinomas tend to invade the adrenal vein and inferior vena cava.
+* Large [[Adrenal gland|adrenal]] [[carcinomas]] tend to invade the [[Adrenal gland|adrenal]] vein and [[inferior vena cava]].
+* On MRI, ACCs appear isointense to hypointense relative to liver parenchyma on T1-weighted images and hyperintense relative to liver parenchyma on T2-weighted images(98).
+* On [[Chemical shift|chemical-shift]] [[Magnetic resonance imaging|MRI]], the presence of [[intracellular]] [[lipid]] can cause regions of signal loss on out-of-phase images relative to inphase images (98).
+* [[Inferior vena cava]] invasion has been reported in 9% to 19% of cases at presentation (98). Due to the multiplanar capability of MRI, direct invasion of adjacent organs may be better shown.
 ==MRI Examples of adrenocortical carcinoma==