Adrenal radiology diagnostics – modern review
https://doi.org/10.24835/10.24835/1607-0763-995
Abstract
In this article we would like to discuss the issues of adrenal pathology and its diagnostics. This is a complex review according to modern sources, fundamental knowledge and author’s experience. All clinical cases are original and morphologically verified. There are different types of classifications with different features, showed in this article. The most useful diagnostic methods are computed tomography (CT) and magnetic resonance imaging (MRI) with special contrast enhancement protocols, described in article.
About the Authors
A. V. ArablinskiyRussian Federation
Andrey V. Arablinskiy, Doct. of Sci. (Med.), Professor of the Department of Radiology and Radiotherapy of Institute of Clinical medicine named after N. V. Sklifosovskiy
8, bld. 2, Trubetskaya str., Moscow, 119991
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
V. D. Rumer
Russian Federation
Veronika B. Rumer, doctor-radiologist of the Department of Radiation Diagnostics
5, 2nd Botkinsky pr., Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
References
1. Sinelnikov R.D., Sinelnikov Ya.R., Sinelnikov A.Ya. Atlas of human anatomy. In 4 volumes. Vol. 2. The doctrine of the entrails and endocrine glands-M.: New Wave, Umerenkov, 2010. (In Russian)
2. Heinz-Peer G. Adrenal masses. Eur. J. Radiol. 2002; 41: 2–17.
3. Prokop M., Galansky M. Spiral and multilayer computed tomography. In 2 volumes. Vol. 1. - M.: Medpress-inform, 2009: 425–438. (In Russian)
4. Lam A.K. Update on Adrenal Tumours in 2017 World Health Organization (WHO) of Endocrine Tumours. Endocr. Pathol. 2017; 28 (3): 213–227. http://doi.org/10.1007/s12022-017-9484-5
5. Cancer Genome Atlas Research Network, Weinstein J.N., Collisson E.A., Mills G.B., Shaw K.R., Ozenberger B.A., Ellrott K., Shmulevich I., Sander C., Stuart J.M. The Cancer Genome Atlas Pan-Cancer analysis project. Nat. Genet. 2013; 45 (10):1113–1120. http://doi.org/10.1038/ng.2764
6. Micali F., Porena M., Vespasiani G., Virgili G. Advances in Diagnosis and Treatment of Adrenal Tumors. In: Pavone-Macaluso M., Smith P.H., Bagshaw M.A. (eds). Testicular Cancer and Other Tumors of the Genitourinary Tract. Ettore Majorana International Science Series. Vol. 8. Boston: Springer, MA, 1985. https://doi.org/10.1007/978-1-4613-2453-9_60
7. Beltsevich D.G., Bokhyan V.Yu., Gorbunova V.A., Kolomeitseva A.A., Kuznetsov N.S., Melnichenko G.A., Perevodchikova N.I., Stilidi I.S. All-Russian Union of Public Associations, Association of Oncologists of Russia, Project clinical recommendations for the treatment of adrenal cortex cancer (adrenocortical cancer). Moscow, 2014. (In Russian)
8. Libé R., Borget I., Ronchi C.L., Zaggia B., Kroiss M., Kerkhofs T., Bertherat J., Volante M., Quinkler M., Chabre O., Bala M., Tabarin A., Beuschlein F., Vezzosi D., Deutschbein T., Borson-Chazot F., Hermsen I., Stell A., Fottner C., Leboulleux S., Hahner S., Mannelli M., Berruti A., Haak H., Terzolo M., Fassnacht M., Baudin E.; ENSAT network. Prognostic factors in stage III–IV adrenocortical carcinomas (ACC): an European Network for the Study of Adrenal Tumor (ENSAT) study. Ann. Oncol. 2015; 26 (10): 2119–2125. https://doi.org/10.1093/annonc/mdv329
9. Peppecorn P.D., Reznek R.H. State-of-the-art CT and MRI of the adrenal gland. Eur. J. Radiol. 1997; 7: 822–836.
10. Arablinsky A.V. Modern radiation diagnostics of volumetric formations of parenchymal organs and some other diseases of the abdominal cavity and retroperitoneal space: Dis ... doctor of medical sciences. M., 1993. 26 p. (In Russian)
11. Koo H.J., Choi H.J., Kim H.J., Kim S.O., Cho K.S. The value of 15-minute delayed contrast-enhanced CT to diffe rentiate hyperattenuating adrenal masses compared with chemical shift MR imaging. Eur. Radiol. 2014; 24 (6): 1410–1420. http://doi.org/10.1007/s00330-013-3084-7
12. Vlasov P.V., Kotlyarov P.M. Radiation diagnostics of diseases of the adrenal glands. Medical visualization. 1999; 4: 31–37. (In Russian)
13. Dubova E.A., Shchegolev A.I., Karmazanovsky G.G. Myelolipoma of the adrenal gland. Medical visualization. 2006; 1: 22–28. (In Russian)
14. Botsikas D., Triponez F., Boudabbous S., Hansen C., Becker C.D., Montet X. Incidental adrenal lesions detected on enhanced abdominal dual-energy CT: can the diagnostic workup be shortened by the implementation of virtual unenhanced images? Eur. J. Radiol. 2014; 83 (10): 1746–1751. http://doi.org/10.1016/j.ejrad.2014.06.017
15. Soroush A., Anbara T., Lashkari M., Mir A. Giant adrenal pseudocyst. Arch. Iran Med. 2013; 16 (12): 741–742. PMID: 24329150.
16. Kumar S., Parmar K.M., Aggarwal D., Jhangra K. Simple adrenal cyst masquerading clinically silent giant cystic pheochromocytoma. BMJ Case Rep. 2019; 12 (9): e230730. http://doi.org/10.1136/bcr-2019-230730
17. Bokhari M.R., Zulfiqar H., Garla V.V. Adrenal Myelolipoma. 2021 Mar 14. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. PMID: 28613782.
18. Choi Y.A., Kim C.K., Park B.K., Kim B. Evaluation of adrenal metastases from renal cell carcinoma and hepatocellular carcinoma: use of delayed contrast-enhanced CT. Radiology. 2013; 266 (2): 514–520. http://doi.org/10.1148/radiol.12120110
19. Johnson P.T., Horton K.M., Fishman E.K. Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls. Radiographics. 2009; 29 (5):1333– 1351. http://doi.org/10.1148/rg.295095027
20. Zhou L., Peng W., Wang C., Liu X., Shen Y., Zhou K. Primary adrenal lymphoma: radiological; pathological, clinical correlation. Eur. J. Radiol. 2012; 81 (3): 401–405. http://doi.org/10.1016/j.ejrad.2010.11.026
21. Elsayes K.M., Emad-Eldin S., Morani A.C., Jensen C.T. Practical Approach to Adrenal Imaging. Radiol. Clin. N. Am. 2017; 55 (2): 279–301. http://doi.org/10.1016/j.rcl.2016.10.005
22. Arablinsky A.V. Computer and magnetic resonance imaging in the diagnosis of diseases of the adrenal glands. Diagnostic and Interventional Radiology. 2011; 5 (1): 95–103. (In Russian)
23. Stepanova Yu.A., Mitina I.E., Shishkina O.I., Vetsheva N.N., Kosova I.A., Berelavichus S.V. Adrenal tumors: clinical and radiation diagnostics (literature review). Medical Visualization. 2014; 2: 48–60. (In Russian)
24. Sohaib S.A., Hanson J.A., Newell-Price J.D., Trainer P.J., Monson J.P., Grossman A.B., Besser G.M., Reznek R.H. CT appearance of the adrenal glands in adrenocorticotrophic hormone-dependent Cushing's syndrome. Am. J. Roentgenol. 1999; 172 (4): 997–1002. http://doi.org/10.2214/ajr.172.4.10587135
25. Francis I.R., Korobkin M. Pheochromocytoma. Radiol. Clin. N. Am. 1996; 34; 1101–1112.
26. Corssmit E.P.M., Dekkers O.M. Screening in adrenal tumors. Curr. Opin. Oncol. 2019; 31 (3): 243–246. http://doi.org/10.1097/CCO.0000000000000528
27. Vetshev P.S., Kondrashin S.A., Ippolitov L.I. Modern angiological technologies in the diagnosis and surgical treatment of adrenal diseases. Medical visualization. 2002; 1: 68–76. (In Russian)
28. Caoili E.M., Korobkin M., Francis I.R., Cohan R.H., Platt J.F., Dunnick N.R., Raghupathi K.I. Adrenal masses: characterization with combined unenhanced and delayed enhanced CT. Radiology. 2002; 222 (3): 629–633. http://doi.org/10.1148/radiol.2223010766
29. Johnson P.T., Horton K.M., Fishman E.K. Adrenal Mass Imaging with Multidetector CT: Pathologic Conditions, Pearls, and Pitfalls. Radiographics. 2009; 29 (5): 1333– 1351. https://doi.org/10.1148/rg.295095027
30. Gajraj H., Young A.E. Adrenal incidentaloma. Br. J. Surg. 1993; 80 (4): 422–426. https://doi.org/10.1002/bjs.1800800405
31. Lee M.J., Hahn P.F., Papanicolaou N., Egglin T.K., Saini S., Mueller P.R., Simeone J.F. Benign and malignant adrenal masses: CT distinction with attenuation coefficients, size, and observer analysis. Radiology. 1991; 179 (2): 415– 418. https://doi.org/10.1148/radiology.179.2.2014283.
32. McGahan J.P. Adrenal gland: MR imaging. Radiology. 1988; 166 (1, Pt 1): 284–285. https://doi.org/10.1148/radiology.166.1.3336697
33. Boland G.W., Lee M.J., Gazelle G.S., Halpern E.F., McNicholas M.M., Mueller P.R. Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. Am. J. Roentgenol. 1998; 171 (1): 201–204. https://doi.org/10.2214/ajr.171.1.9648789
34. Fassnacht M., Arlt W., Bancos I., Dralle H., Newell-Price J., Sahdev A., Tabarin A., Terzolo M., Tsagarakis S., Dekkers O.M. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur. J. Endocrinol. 2016; 175 (2): G1–G34. https://doi.org/10.1530/EJE-16-0467
Supplementary files
Review
For citations:
Arablinskiy A.V., Rumer V.D. Adrenal radiology diagnostics – modern review. Medical Visualization. 2021;25(2):21-41. (In Russ.) https://doi.org/10.24835/10.24835/1607-0763-995