The value of signal intensity on T1-weighted chemical shift magnetic resonance imaging combined with proton magnetic resonance spectroscopy for the diagnosis of adrenal adenomas

Dalavia, Claudio Carvalho; Goldman, Suzan Menasce; Melo, Homero José de Farias e; Kater, Cláudio E.; Szejnfeld, Jacob; Iared, Wagner; Ajzen, Sérgio Aron

doi:10.1590/0100-3984.2019.0095

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…Another parameter that was assessed in our study was signal homogeneity on T2-weighted images. On such images, adrenal adenomas are reportedly more homogeneous than are primary or metastatic malignant lesions and other benign lesions such as pheochromocytomas and myelolipomas ( 21 , 26 - 28 ) , which tend to be heterogeneous, especially if they are large. In our study, we did not find any markedly heterogeneous adrenal adenomas, and the proportion of mildly heterogeneous lesions did not differ significantly between the two readers, findings that are in keeping with those in the literature.…”

Section: Discussionmentioning

confidence: 99%

Frequency of lipid-poor adrenal adenomas in magnetic resonance imaging examinations of the abdomen

et al. 2022

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Objective: To estimate the frequency of lipid-poor adenomas (LPAs) in magnetic resonance imaging (MRI) examinations. Materials and Methods: We retrospectively investigated adrenal lesions on MRI examinations performed in a total of 2,014 patients between January 2016 and December 2017. After exclusions, the sample comprised 69 patients with 74 proven adenomas. Two readers (reader 1 and reader 2) evaluated lesion size, laterality, homogeneity, signal drop on out-of-phase (OP) images, and the signal intensity index (SII). An LPA was defined as a lesion with no signal drop on OP images and an SII < 16.5%. For 68 lesions, computed tomography (CT) scans (obtained within one year of the MRI) were also reviewed. Results: Of the 69 patients evaluated, 42 (60.8%) were women and 27 (39.2%) were men. The mean age was 59.2 ± 14.1 years. Among the 74 confirmed adrenal adenomas evaluated, the mean lesion size was 18.5 ± 7.7 mm (range, 7.0-56.0 mm) for reader 1 and 21.0 ± 8.3 mm (range, 7.0-55.0 mm) for reader 2 (p = 0.055). On the basis of the signal drop in OP MRI sequences, both readers identified five (6.8%) of the 74 lesions as being LPAs. When determined on the basis of the SII, that frequency was three (4.0%) for reader 1 and four (5.4%) for reader 2. On CT, 21 (30.8%) of the 68 lesions evaluated were classified as LPAs. Conclusion: The prevalence of LPA was significantly lower on MRI than on CT. That prevalence tends to be even lower when the definition of LPA relies on a quantitative analysis rather than on a qualitative (visual) analysis.

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Section: Discussionmentioning

confidence: 99%

Frequency of lipid-poor adrenal adenomas in magnetic resonance imaging examinations of the abdomen

et al. 2022

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Differentiation between adrenocortical carcinoma and lipid-poor adrenal adenoma using a multiparametric MRI-based diagnostic algorithm

Oloukoi,

Dohan,

Gaillard

et al. 2024

Diagnostic and Interventional Imaging

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Is it Possible to Assess the Functional Status of Hormone Secretion or Non- Secretion of Adrenal Masses Through Their Magnetic Resonance Imaging (MRI) Characteristics?

Akkuş

Pişkin

Karagun

et al. 2022

EMIDDT

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Background: Diagnostic imaging techniques including magnetic resonance imaging (MRI) should also perform on all patients with incidentalomas. However, there is a limited study whether the quantitative measurements (signal intensity index, adrenal to spleen ratio) in MRI could predict the functional status of adrenal adenomas. Material-Method: Between 2015-2020; 404 patients (265 females, 139 males) with adrenal mass who were referred to the university hospital for further investigation were included. After detailed diagnostic hormonal evaluation, all patients underwent MRI 1.5 T device (Signa, GE Medical Systems; Milwaukee, USA). The signal intensities of the adrenal lesions on T2W images were qualitatively evaluated and noted as homogenous or heterogeneous in comparison with the liver signal intensity (SI). A chemical-shift SI index and chemical shift adrenal-to-spleen SI ratio were also calculated. Results: While 331(81.9%) of the patients had nonfunctional adrenal mass, the rest of them (n=73, 18.1%) were patients with functional (autonomous cortisol secretion-ACS, cushing syndrome-CS, pheochromocytoma, primary hyperaldosteronism-PA) adrenal masses. In phase vs phase values of patients with NFAI, Pheo(n=17), ACS (n=30), CS (n=11), and PA (n=15) were 474.04±126.7 vs 226.6±132.4, 495.3±182.8 vs 282.17±189.1, 445.2±134.8 vs 203.3±76.2, 506.8±126.5 vs 212.2±73.6 and 496.2±147.5 vs 246.6±102.1, respectively. Mean signal intensity index (SII) and adrenal to spleen ratio (ASR) of all groups (NFAI, Pheo, ACS, CS, PA) were 52.0±24.8 and 0.51, 44.9±22.5 and 0.55, 49.5±24.5 and 0.53, 56.2±16.4 and 0.43, 47.6±25.1 and 0.54, respectively. Based the current accepted measurements in the case of ASR and SII, all lesions were similar and shown as fat rich adenomas (p*= 0.552, p** = 0.45). Conclusion: The quantitative assessment (SII, ASR) of intracellular lipids in an incidentally discovered adrenal tumour could only help distinguish adrenal masses in case of adenomas or non-adenomas As initial diagnostic evaluation, clinical and laboratory assessment ,to distinguish hormone secretion, should be taken in all patients with adrenal incidentalomas.

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The value of signal intensity on T1-weighted chemical shift magnetic resonance imaging combined with proton magnetic resonance spectroscopy for the diagnosis of adrenal adenomas

Cited by 3 publications

References 29 publications

Frequency of lipid-poor adrenal adenomas in magnetic resonance imaging examinations of the abdomen

Frequency of lipid-poor adrenal adenomas in magnetic resonance imaging examinations of the abdomen

Differentiation between adrenocortical carcinoma and lipid-poor adrenal adenoma using a multiparametric MRI-based diagnostic algorithm

Is it Possible to Assess the Functional Status of Hormone Secretion or Non- Secretion of Adrenal Masses Through Their Magnetic Resonance Imaging (MRI) Characteristics?

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