Adrenal hemorrhage after orthotopic liver transplantation: MR appearance.
The purpose of this paper is to describe the MR imaging findings of right adrenal hemorrhage after orthotopic liver transplantation. Twenty-seven orthotopic liver transplantation patients underwent MR studies of the liver and/or biliary system. Patients were referred to MR examination because of suspected biliary complications ( n=22) or for evaluation of mass lesions ( n=5). The standard MR protocol included T1-weighted spin-echo (SE) or gradient-recalled echo (GRE) images and T2-weighted turbo SE (TSE) images with fat suppression. In addition, cholangiography pulse sequences and/or contrast-enhanced T1-weighted images were obtained according to specific indications. In 2 patients a right adrenal mass was detected at MR imaging. Three to 4 weeks after transplantation, the lesions were markedly hyperintense on T2-weighted images and showed a hypointense capsule. Follow-up MR examinations revealed a slight decrease in size and a change in morphology. Computed tomography examinations of these 2 patients, obtained 10 weeks after transplantation, showed resolution of the hemorrhage and transformation into a cystic lesion in one case and a complete resolution of the hemorrhage and a normal right adrenal gland in the other case. Adrenal hemorrhage after liver transplantation shows typical MR features and should not be mistaken for an adrenal tumor or a postoperative abscess.
Prokesch
R W
RW
Present address: Department of Radiology, Stanford University, Lucas MRS Center, 1201 Welch Road, Stanford, CA 94305-5488, USA. rupert.prokesch@stanford.edu
Schima
W
W
Berlakovich
G
G
Zacherl
J
J
D000307:Adrenal Gland Diseases / Q000175:diagnosis*; D000311:Adrenal Glands / Q000473:pathology; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis*; D012075:Remission, Spontaneous; D014057:Tomography, X-Ray Computed