Differentiation of adrenal masses with MR imaging: comparison of techniques.
OBJECTIVE
To determine the efficacy of various magnetic resonance (MR) imaging sequences for the differentiation of adrenal masses.


METHODS
Fifty-three adrenal masses in 46 patients (adenomas, metastases, myelolipomas, hemorrhages, and pheochromocytomas) were evaluated by means of T1-, T2-, and T2*-weighted sequences, calculated T2 values, chemical shift imaging techniques, and dynamic contrast material-enhanced imaging. The Student t test and receiver operating characteristic analysis were used to evaluate the differences in the groups of masses.


RESULTS
Analysis of the chemical shift-induced signal intensity of the adrenal masses and the T2*-weighted sequence enabled differentiation of adenomas, metastases, and pheochromocytomas. Adenomas and pheochromocytomas were also differentiated by means of a heavily T2-weighted sequence. Signal intensity values for all masses overlapped.


CONCLUSIONS
Although a chemical shift imaging technique and a T2*-weighted sequence helped correctly differentiate among the groups of adrenal masses, the degree of overlap suggests that it is still difficult to evaluate disease in individual patients.
Reinig
J W
JW
Anne Arundel MRI, Annapolis, MD 21403.
Stutley
J E
JE
Leonhardt
C M
CM
Spicer
K M
KM
Margolis
M
M
Caldwell
C B
CB
D000236:Adenoma / Q000175:diagnosis; D000307:Adrenal Gland Diseases / Q000175:diagnosis*; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000556:secondary; D003937:Diagnosis, Differential; D006470:Hemorrhage / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010673:Pheochromocytoma / Q000175:diagnosis; D011446:Prospective Studies; D012372:ROC Curve