Adrenocortical carcinoma: MR imaging appearance with current techniques

Abstract

The purpose of the study was to define the magnetic resonance (MR) imaging appearance of adrenocortical carcinoma (ACC) with current MR techniques. Eight patients with ACC underwent high-field-strength MR imaging with the following sequences: axial T1-weighted gradient echo, fat-suppressed T1-weighted spin echo, fat-suppressed T2-weighted spin echo, and gadolinium-enhanced T1-weighted gradient echo and fat-suppressed T1-weighted spin echo. Postcontrast images were also acquired in the sagittal (six patients) and coronal (three patients) planes. Out-of-phase gradient-echo images were obtained in two patients. Lesion morphology, signal intensity features, and presence of metastatic disease were retrospectively evaluated. MR imaging features of ACC included internal hemorrhage (seven of eight patients), central necrosis (seven of eight), and peripheral enhancing nodules (seven of eight). Out-of-phase images in two of two patients demonstrated signal loss compared with in-phase images, which may be a common feature of these tumors. Liver metastases were present in four patients. Consistent MR features of ACC are identified.

Giant adrenal myelolipoma with minimal fat content in a patient with homozygous beta‐thalassemia: Appearance on MRI

“…The rare adrenal cortical carcinomas are large, lobulated tumors; they are frequently hormonally active, more common in female patients, and usually contain areas of necrosis and hemorrhage with inhomogeneous high SI on T2-weighted sequences. They may exhibit signal drop on opposed-phase images, which is usually inhomogeneous and may extend up to 15% of the total tumor volume (9). When adrenal cortical carcinomas are large, other signs of malignancy, such as lymph nodes, metastases and extent in the inferior vena cava (IVC) are commonly present (9).…”

“…They may exhibit signal drop on opposed-phase images, which is usually inhomogeneous and may extend up to 15% of the total tumor volume (9). When adrenal cortical carcinomas are large, other signs of malignancy, such as lymph nodes, metastases and extent in the inferior vena cava (IVC) are commonly present (9). In our case, the patient was male, the tumor was ovoid, not lobulated, and there was no evidence of central necrosis or other signs of malignancy.…”

Computed tomography and magnetic resonance imaging of adrenal lesions

“…Heterogena postkontrastna opacifikacija, sa sporim ispiranjem je karakterističan prikaz na kompjutoriziranoj tomografiji 48,54 . Na T1 mjerenim slikama na magnetskoj rezonanciji je obično blago hipointenzan u odnosu na jetru, ponekad s arealima visokog T1 signala u slučaju hemoragije.…”

“…Na T1 mjerenim slikama na magnetskoj rezonanciji je obično blago hipointenzan u odnosu na jetru, ponekad s arealima visokog T1 signala u slučaju hemoragije. U T2 mjerenim slikama je višeg signala u odnosu na jetru, heterogenog prikaza, s arealima hemoragije i nekroze 54 . Može imati i areale masti koji pokazuju pad signala u T1 mjerenim slikama izvan faze, kao i adenomi.…”

“…Može imati i areale masti koji pokazuju pad signala u T1 mjerenim slikama izvan faze, kao i adenomi. Treba naglasiti da je adrenokortikalni karcinom uvijek heterogenog prikaza za razliku od adenoma 54 (slika 8a, b).…”