Learning objectives
To review the imaging features in a normal adrenal gland in ultrasound (US),
computed tomography (CT) and magnet resonance (MR).
To illustrate common and uncommon adrenal glands diseases.
Background
The adrenal glands are paired organs of the endocrine system that lie in the perirenal space of the retroperitoneum; each of them is composed of a body and two limbs (medial and lateral),
weighs about 4-5 g,
and typically has an inverted-V,
Y or T shape.
The adrenal glands receive blood supply from the superior,
middle and inferior suprarenal arteries,
which originate from the inferior phrenic arteries,
abdominal aorta,
and renal arteries,
respectively.
The venous drainage of each adrenal gland is via a single vein...
Findings and procedure details
Adrenal abnormalities can be classified according to size,
endocrinologic signature,
morphologic features or biologic behavior.
For the radiologist,
however,
it is more important to acknowledge the imaging features that can help distinguish benign from malignant lesions.
Benign adrenal masses include adrenal hyperplasia,
adenoma,
myelolipoma,
hemorrhage,
adrenal cyst and granulomatous disease.
Malignant adrenal masses include metastasis and lymphoma.
Although the ultrasound is not very accurate to identify the adrenal glands,
it is widely used as a screening exam for assessing any abdominal abnormalities and as a...
Conclusion
Radiologists play an important role in the identification and diagnosis of adrenal lesions,
as they help the referring physician to decide the next step in management,
especially for an oncologic patient.
Acknowledgement of the main imaging features of benign and malignant adrenal masses is critical for the radiologist,
and even though most adrenal masses found as incidentalomas are adenomas,
correct assessment of the lesion is key in the diagnostic process to provide optimal care and to minimize unnecessary expenses and stress for patients.
References
Lattin GE,
Sturgill ED,
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Marko J,
Sanchez-Maldonado KW,
Craig WD,
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From the Radiologic Pathology Archives Adrenal Tumors and Tumor-like Conditions in the Adult: Radiologic-Pathologic Correlation.
RadioGraphics.
2014 May-June;34:805-829.
Boland GWL,
Blake MA,
Hahn PF,
Mayo-Smith WW.
Incidental Adrenal Lesions: Principles,
Techniques,
and Algorithms for Imaging Characterization.
Radiology.
2008 Nov-Dec;249(3):756-775.
Wan YL.
Ultrasonography of the Adrenal Gland.
J Med Ultrasound.
2007;15(4):213-227.
Elsayes KM,
Mukundan Govind,
Narra VM,
Lewis Jr JS,
Shirkhoda A,
Farooki A,
Brown JJ.
Adrenal Masses: MR Imaging Features with...