Abstract
The adrenal gland is involved by a range of neoplasms, including primary and metastatic malignant tumors; however, the most common tumor detected is the incidental benign adenoma. Although computed tomographic (CT) findings will not always yield a definitive diagnosis, attention to these findings provides a road map to guide image interpretation. Adenomas typically demonstrate rapid washout, which is defined as an absolute percentage washout (APW) of more than 60% and a relative percentage washout (RPW) of more than 40% on delayed images. Adrenocortical carcinoma typically has an RPW of less than 40%; however, large size and heterogeneity are more reliable indicators of the diagnosis than are washout values. Washout characterissics of pheochromocytoma are variable; in conjunction with high levels of dynamic enhancement, pheochromocytomas may mimic adenoma (ie, APW > 60%, RPW > 40%). Myelolipomas appear as well-defined masses with variable quantities of fat and soft tissue. After contrast material administration, metastases usually demonstrate slower washout on delayed images (APW <60%, RPW <40%) than do adenomas, although hypervascular metastases may enhance similarly to pheochromocytoma. Finally, a number of nonadrenal pathologic conditions have been reported to mimic adrenal masses at CT.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1333-1351 |
| Number of pages | 19 |
| Journal | Radiographics : a review publication of the Radiological Society of North America, Inc |
| Volume | 29 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 2009 |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Medicine(all)
Cite this
Adrenal mass imaging with multidetector Ct : Pathologic conditions, pearls, and pitfall. / Johnson, Pamela; Horton, Karen M; Fishman, Elliot K.
In: Radiographics : a review publication of the Radiological Society of North America, Inc, Vol. 29, No. 5, 09.2009, p. 1333-1351.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Adrenal mass imaging with multidetector Ct
T2 - Pathologic conditions, pearls, and pitfall
AU - Johnson, Pamela
AU - Horton, Karen M
AU - Fishman, Elliot K
PY - 2009/9
Y1 - 2009/9
N2 - The adrenal gland is involved by a range of neoplasms, including primary and metastatic malignant tumors; however, the most common tumor detected is the incidental benign adenoma. Although computed tomographic (CT) findings will not always yield a definitive diagnosis, attention to these findings provides a road map to guide image interpretation. Adenomas typically demonstrate rapid washout, which is defined as an absolute percentage washout (APW) of more than 60% and a relative percentage washout (RPW) of more than 40% on delayed images. Adrenocortical carcinoma typically has an RPW of less than 40%; however, large size and heterogeneity are more reliable indicators of the diagnosis than are washout values. Washout characterissics of pheochromocytoma are variable; in conjunction with high levels of dynamic enhancement, pheochromocytomas may mimic adenoma (ie, APW > 60%, RPW > 40%). Myelolipomas appear as well-defined masses with variable quantities of fat and soft tissue. After contrast material administration, metastases usually demonstrate slower washout on delayed images (APW <60%, RPW <40%) than do adenomas, although hypervascular metastases may enhance similarly to pheochromocytoma. Finally, a number of nonadrenal pathologic conditions have been reported to mimic adrenal masses at CT.
AB - The adrenal gland is involved by a range of neoplasms, including primary and metastatic malignant tumors; however, the most common tumor detected is the incidental benign adenoma. Although computed tomographic (CT) findings will not always yield a definitive diagnosis, attention to these findings provides a road map to guide image interpretation. Adenomas typically demonstrate rapid washout, which is defined as an absolute percentage washout (APW) of more than 60% and a relative percentage washout (RPW) of more than 40% on delayed images. Adrenocortical carcinoma typically has an RPW of less than 40%; however, large size and heterogeneity are more reliable indicators of the diagnosis than are washout values. Washout characterissics of pheochromocytoma are variable; in conjunction with high levels of dynamic enhancement, pheochromocytomas may mimic adenoma (ie, APW > 60%, RPW > 40%). Myelolipomas appear as well-defined masses with variable quantities of fat and soft tissue. After contrast material administration, metastases usually demonstrate slower washout on delayed images (APW <60%, RPW <40%) than do adenomas, although hypervascular metastases may enhance similarly to pheochromocytoma. Finally, a number of nonadrenal pathologic conditions have been reported to mimic adrenal masses at CT.
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UR - http://www.scopus.com/inward/citedby.url?scp=70349926205&partnerID=8YFLogxK
U2 - 10.1148/rg.295095027
DO - 10.1148/rg.295095027
M3 - Article
C2 - 19755599
AN - SCOPUS:70349926205
VL - 29
SP - 1333
EP - 1351
JO - Radiographics
JF - Radiographics
SN - 0271-5333
IS - 5
ER -