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Adrenal adenoma: Difference between revisions

Adrenal adenoma (view source)

Revision as of 14:56, 21 December 2023

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<section begin="radiology" />
<section begin="radiology" />
==Evaluation==
==Evaluation==
Certain [[CT]] characteristics increase the risk of the incidentaloma being [[adrenal carcinoma]]. Benign findings include small size, low density (< 10 HU) due to containing mostly adipose tissue, smooth border, rapid contrast washout. Malignant findings include irregular shape, inhomogeneous density, and delayed contrast washout. MRI with in-phase and out-phase can also help distinguish it from carcinoma.  
Certain [[CT]] characteristics increase the risk of the incidentaloma being [[adrenal carcinoma]]. Benign findings include small size, low density (< 10 HU) due to containing mostly adipose tissue, smooth border, rapid contrast washout. Malignant findings include irregular shape, inhomogeneous density, and delayed contrast washout. MRI with in-phase and out-phase can also help distinguish it from carcinoma. <section end="radiology" />
<section end="radiology" />
 
Adrenal washout refers to the rate of intravenous CT contrast washout of the adrenal gland, which can help distinguish adenoma from other pathologies:
 
* > 60% absolute washout (AWO) or > 40% relative washout (RWO) makes adenoma most likely
* < 50% washout indicates adrenal metastasis
 
If phaeochromocytoma is suspected, 24-hour urinary metanephrines should be measured. Patients may undergo dexamethasone suppression test to detect subclinical Cushing syndrome.
If phaeochromocytoma is suspected, 24-hour urinary metanephrines should be measured. Patients may undergo dexamethasone suppression test to detect subclinical Cushing syndrome.