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Clinical MRI of the Abdomen pp 301–334Cite as

Adrenal Incidentalomas

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Abstract

Asymptomatic adrenal masses – “incidentalomas” – have become a common clinical and diagnostic problem with increasing prevalence, mainly due to advances in abdominal imaging technology. The prevalence of these lesions increases with age, and an appropriate diagnostic work-up is a growing challenge in our ageing society.

Unsuspected adrenal masses are detected in up to 5% of abdominal imaging procedures, and the limited availability of studies on incidence, prevalence and natural development complicates the decision regarding diagnostic work-up.

The majority of asymptomatic adrenal masses are non-hyperfunctioning adenomas. However, there are a large number of entities also appearing as non-functioning adrenal lesions. While each type of incidentally found non-adenomas is itself rare, altogether they represent a substantial amount. Most of these lesions do not have specific imaging features. Nevertheless, radiological evaluation usually allows narrowing of the differential diagnosis. Magnetic Resonance Imaging (MRI) is considered an excellent tool in the differentiation between adenomatous and non-adenomatous adrenal masses. Even in cases which are indeterminate on CT, the nature of the adrenal lesion can often be determined using MRI.

Chapter “Adrenal incidentalomas” is a full review of state of the art in imaging and diagnosis of adrenal lesions, which could appear as incidentalomas of the adrenal glands. Different competitive imaging methods are discussed and compared, with focus on MRI techniques and a comprehensive description of the epidemiology and pathophysiology of adrenal lesions is given.

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References

  1. Geelhoed GW, Spiegel CT (1981) “Incidental” adrenal cyst: a correctable lesion possibly associated with hypertension. South Med J 74:626–630

    Article  PubMed  CAS  Google Scholar 

  2. Prinz RA, Brooks MH et al (1982) Incidental asymptomatic adrenal masses detected by computed tomographic scanning. Is operation required? JAMA 248:701–704

    Article  PubMed  CAS  Google Scholar 

  3. Grumbach MM, Biller BM et al (2003) Management of the clinically inapparent adrenal mass (“incidentaloma”). Ann Intern Med 138:424–429

    PubMed  Google Scholar 

  4. Bertherat J, Mosnier-Pudar H et al (2002) Adrenal incidentalomas. Curr Opin Oncol 14:58–63

    Article  PubMed  Google Scholar 

  5. Reincke M, Slawik M (2007) Adrenal incidentalomas. Endotext.com. http://www.endotext.org/adrenal/adrenal20/adrenalframe20.htm. Accessed November 2008

    Google Scholar 

  6. Tsushima Y, Ishizaka H et al (1992) Differential diagnosis of adrenal masses using out-of-phase FLASH imaging. A preliminary report. Acta Radiol 33:262–265

    PubMed  CAS  Google Scholar 

  7. Tsushima Y, Ishizaka H et al (1993) Adrenal masses: differentiation with chemical shift, fast low-angle shot MR imaging. Radiology 186:705–709

    PubMed  CAS  Google Scholar 

  8. Mitchell DG, Crovello M et al (1992) Benign adrenocortical masses: diagnosis with chemical shift MR imaging. Radiology 185:345–351

    PubMed  CAS  Google Scholar 

  9. Mayo-Smith WW, Boland GW et al (2001) State-of-the-art adrenal imaging. Radiographics 21:995–1012

    PubMed  CAS  Google Scholar 

  10. Elsayes KM, Mukundan G et al (2004) Adrenal masses: MR imaging features with pathologic correlation. Radiographics 24(Suppl 1):S73–S86

    Article  PubMed  Google Scholar 

  11. Krestin GP, Steinbrich W et al (1989) Adrenal masses: evaluation with fast gradient-echo MR imaging and Gd-DTPA-enhanced dynamic studies. Radiology 171:675–680

    PubMed  CAS  Google Scholar 

  12. Kelekis NL, Semelka RC et al (2006) Adrenal glands. In: Semelka RC (ed) Abdominal-pelvic MRI, 2nd edn. Wiley, New Jersey

    Google Scholar 

  13. Dunnick NR (1994) Adrenal carcinoma. Radiol Clin North Am 32:99–108

    PubMed  CAS  Google Scholar 

  14. Uwaifo GI (2006) Adrenal carcinoma. E-medicine. http://www.emedicine.com/med/topic63.htm. Accessed November 2008

    Google Scholar 

  15. Kawashima A, Sandler CM et al (1999) Imaging of nontraumatic hemorrhage of the adrenal gland. Radiographics 19:949–963

    PubMed  CAS  Google Scholar 

  16. Fox B (1976) Venous infarction of the adrenal glands. J Pathol 119:65–89

    Article  PubMed  CAS  Google Scholar 

  17. Otal P, Escourrou G et al (1999) Imaging features of uncommon adrenal masses with histopathologic correlation. Radiographics 19:569–581

    PubMed  CAS  Google Scholar 

  18. Tung GA, Pfister RC et al (1989) Adrenal cysts: imaging and percutaneous aspiration. Radiology 173:107–110

    PubMed  CAS  Google Scholar 

  19. Rozenblit A, Morehouse HT et al (1996) Cystic adrenal lesions: CT features. Radiology 201:541–548

    PubMed  CAS  Google Scholar 

  20. Meaglia JP, Schmidt JD (1992) Natural history of an adrenal myelolipoma. J Urol 147:1089–1090

    PubMed  CAS  Google Scholar 

  21. Collins DC (1932) Formation of bone marrow in the suprarenal gland. Am J Pathol 8:97–106

    PubMed  CAS  Google Scholar 

  22. Ramchandani P (2007) Adrenal myelolipoma. E-medicine. http://www.emedicine.com/radio/topic18.htm. Accessed November 2008

    Google Scholar 

  23. Dunnick NR, Korobkin M (2002) Imaging of adrenal incidentalomas: current status. Am J Roentgenol 179:559–568

    Google Scholar 

  24. Korobkin M, Brodeur FJ et al (1998) CT time-attenuation washout curves of adrenal adenomas and nonadenomas. Am J Roentgenol 170:747–752

    CAS  Google Scholar 

  25. Rha SE, Byun JY et al (2003) Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics 23:29–43

    Article  PubMed  Google Scholar 

  26. Blake MA, Kalra MK et al (2004) Pheochromocytoma: an imaging chameleon. Radiographics 24(Suppl 1):S87–S99

    Article  PubMed  Google Scholar 

  27. Park BK, Kim CK et al (2007) Adrenal tumors with late enhancement on CT and MRI. Abdom Imaging 32: 515–518

    Article  PubMed  Google Scholar 

  28. Ichikawa T, Koyama A et al (1993) Retroperitoneal ganglioneuroma extending across the midline: MR features. Clin Imaging 17:19–21

    Article  PubMed  CAS  Google Scholar 

  29. West SF (2008) Neuroblastoma. E-medicine. http://www.emedicine.com/radio/topic472.htm. Accessed November 2008

    Google Scholar 

  30. Wilms GE, Baert AL et al (1983) Computed tomographic findings in bilateral adrenal tuberculosis. Radiology 146:729–730

    PubMed  CAS  Google Scholar 

  31. Burrill J, Williams CJ et al (2007) Tuberculosis: a radiologic review. Radiographics 27:1255–1273

    Article  PubMed  Google Scholar 

  32. Wilson DA, Muchmore HG et al (1984) Histoplasmosis of the adrenal glands studied by CT. Radiology 150:779–783

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Erasmus University Medical Center, 2040, 3000 CA, Rotterdam, The Netherlands

    Marzena Kulawska-Didoszak & Gabriel P. Krestin

Authors
  1. Marzena Kulawska-Didoszak
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  2. Gabriel P. Krestin
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Correspondence to Marzena Kulawska-Didoszak .

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Editors and Affiliations

  1. Dept. Radiology, University Hospital Iraklion, Stavrakia 1352, Iraklion, Crete, 711 10, Greece

    Nicholas C. Gourtsoyiannis

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© 2009 Springer Berlin Heidelberg

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Kulawska-Didoszak, M., Krestin, G.P. (2009). Adrenal Incidentalomas. In: Gourtsoyiannis, N. (eds) Clinical MRI of the Abdomen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85689-4_13

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  • DOI: https://doi.org/10.1007/978-3-540-85689-4_13

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-85688-7

  • Online ISBN: 978-3-540-85689-4

  • eBook Packages: MedicineMedicine (R0)

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