Adrenocortical carcinoma MRI
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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 may 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.