Adrenocortical carcinoma MRI: Difference between revisions
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==Overview== | ==Overview== | ||
[[MRI]] scans are helpful in differentiating between [[adrenal adenoma]], carcinoma, and [[Metastasis|metastatic]] lesions. Due to the multiplanar capability of [[MRI]], direct invasion of adjacent organs may be better shown. [[Inferior vena cava]] invasion has been reported in 9% to 19% of cases at presentation. | [[MRI]] scans are helpful in differentiating between [[adrenal adenoma]], [[carcinoma]], and [[Metastasis|metastatic]] lesions. Due to the multiplanar capability of [[MRI]], direct [[invasion]] of adjacent [[organs]] may be better shown. [[Inferior vena cava]] [[invasion]] has been reported in 9% to 19% of cases at presentation. | ||
==MRI Findings in adrenocortical carcinoma== | ==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]].<ref name="pmid21606258">{{cite journal| author=Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB et al.| title=Adrenocortical carcinoma: the range of appearances on CT and MRI. | journal=AJR Am J Roentgenol | year= 2011 | volume= 196 | issue= 6 | pages= W706-14 | pmid=21606258 | doi=10.2214/AJR.10.5540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21606258 }}</ref> | * 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]].<ref name="pmid21606258">{{cite journal| author=Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB et al.| title=Adrenocortical carcinoma: the range of appearances on CT and MRI. | journal=AJR Am J Roentgenol | year= 2011 | volume= 196 | issue= 6 | pages= W706-14 | pmid=21606258 | doi=10.2214/AJR.10.5540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21606258 }}</ref> | ||
* Adrenocortical carcinoma can contain foci of intra[[cytoplasmic]] [[lipid]], which results in a loss of signal intensity on out-of-phase images.<ref name="pmid12478091">{{cite journal| author=Ng L, Libertino JM| title=Adrenocortical carcinoma: diagnosis, evaluation and treatment. | journal=J Urol | year= 2003 | volume= 169 | issue= 1 | pages= 5-11 | pmid=12478091 | doi=10.1097/01.ju.0000030148.59051.35 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12478091 }}</ref> | * Adrenocortical carcinoma can contain foci of intra[[cytoplasmic]] [[lipid]], which results in a loss of signal intensity on out-of-phase images.<ref name="pmid12478091">{{cite journal| author=Ng L, Libertino JM| title=Adrenocortical carcinoma: diagnosis, evaluation and treatment. | journal=J Urol | year= 2003 | volume= 169 | issue= 1 | pages= 5-11 | pmid=12478091 | doi=10.1097/01.ju.0000030148.59051.35 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12478091 }}</ref> | ||
* Large [[Adrenal gland|adrenal]] [[carcinomas]] tend to invade the [[Adrenal gland|adrenal]] vein and [[inferior vena cava]].<ref name="pmid21606258" /> | * Large [[Adrenal gland|adrenal]] [[carcinomas]] tend to invade the [[Adrenal gland|adrenal]] [[vein]] and [[inferior vena cava]].<ref name="pmid21606258" /> | ||
* On [[Magnetic resonance imaging|MRI]], ACCs appear isointense to hypointense relative to [[liver]] parenchyma on T1-weighted images and hyperintense relative to [[liver]] [[parenchyma]] on T2-weighted images.<ref name="pmid216062582">{{cite journal| author=Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB et al.| title=Adrenocortical carcinoma: the range of appearances on CT and MRI. | journal=AJR Am J Roentgenol | year= 2011 | volume= 196 | issue= 6 | pages= W706-14 | pmid=21606258 | doi=10.2214/AJR.10.5540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21606258 }}</ref> | * On [[Magnetic resonance imaging|MRI]], ACCs appear isointense to hypointense relative to [[liver]] parenchyma on T1-weighted images and hyperintense relative to [[liver]] [[parenchyma]] on T2-weighted images.<ref name="pmid216062582">{{cite journal| author=Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB et al.| title=Adrenocortical carcinoma: the range of appearances on CT and MRI. | journal=AJR Am J Roentgenol | year= 2011 | volume= 196 | issue= 6 | pages= W706-14 | pmid=21606258 | doi=10.2214/AJR.10.5540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21606258 }}</ref> | ||
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* [[Inferior vena cava]] invasion has been reported in 9% to 19% of cases at presentation. | * [[Inferior vena cava]] invasion has been reported in 9% to 19% of cases at presentation. | ||
* Due to the multiplanar capability of [[Magnetic resonance imaging|MRI]], [[Invasion|direct invasion]] of adjacent organs may be better shown. | * Due to the multiplanar capability of [[Magnetic resonance imaging|MRI]], [[Invasion|direct invasion]] of adjacent [[organs]] may be better shown. | ||
==MRI Examples of adrenocortical carcinoma== | ==MRI Examples of adrenocortical carcinoma== | ||
Revision as of 12:23, 2 October 2017
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Adrenocortical carcinoma Microchapters |
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Differentiating Adrenocortical carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Study |
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Adrenocortical carcinoma MRI On the Web |
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American Roentgen Ray Society Images of Adrenocortical carcinoma MRI |
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Risk calculators and risk factors for Adrenocortical carcinoma MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2] Mohammed Abdelwahed M.D[3]
Overview
MRI scans are helpful in differentiating between adrenal adenoma, carcinoma, and metastatic lesions. Due to the multiplanar capability of MRI, direct invasion of adjacent organs may be better shown. Inferior vena cava invasion has been reported in 9% to 19% of cases at presentation.
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.[1]
- Adrenocortical carcinoma can contain foci of intracytoplasmic lipid, which results in a loss of signal intensity on out-of-phase images.[2]
- Large adrenal carcinomas tend to invade the adrenal vein and inferior vena cava.[1]
- 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.[3]
- On chemical-shift MRI, the presence of intracellular lipid can cause regions of signal loss on out-of-phase images relative to in-phase images.[4]
- Inferior vena cava invasion has been reported in 9% to 19% of cases at presentation.
- Due to the multiplanar capability of MRI, direct invasion of adjacent organs may be better shown.
MRI Examples of adrenocortical carcinoma
Source: Case courtesy of Radswiki, Radiopaedia.org, rID: 11176
References
- ↑ 1.0 1.1 Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB; et al. (2011). "Adrenocortical carcinoma: the range of appearances on CT and MRI". AJR Am J Roentgenol. 196 (6): W706–14. doi:10.2214/AJR.10.5540. PMID 21606258.
- ↑ Ng L, Libertino JM (2003). "Adrenocortical carcinoma: diagnosis, evaluation and treatment". J Urol. 169 (1): 5–11. doi:10.1097/01.ju.0000030148.59051.35. PMID 12478091.
- ↑ Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB; et al. (2011). "Adrenocortical carcinoma: the range of appearances on CT and MRI". AJR Am J Roentgenol. 196 (6): W706–14. doi:10.2214/AJR.10.5540. PMID 21606258.
- ↑ Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB; et al. (2011). "Adrenocortical carcinoma: the range of appearances on CT and MRI". AJR Am J Roentgenol. 196 (6): W706–14. doi:10.2214/AJR.10.5540. PMID 21606258.