Radiology Lectures | Radquarters

Non-masslike Adrenal Abnormalities


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In this video lecture, we discuss the normal imaging appearance of the adrenal glands, as well as multiple common and rare non-masslike adrenal abnormalities on CT and MRI.

Key points include:

  • The adrenal glands normally have an inverted “V”
or “Y” configuration.
  • A linear, disk-like adrenal gland or “pancake”
  • adrenal gland indicates congenital malposition or absence of the ipsilateral
    kidney.
  • Adrenal hyperenhancement raises suspicion for
  • developing shock and may signal a therapeutic window to act upon.
  • Adrenal calcifications can be caused by prior
  • hemorrhage, infection, tumors and metabolic syndromes.
  • On MRI, T1-weighted in-phase GRE images can be
  • helpful in identifying calcification due to dark blooming caused by susceptibility
    artifact.
  • Adrenal atrophy may indicate adrenal
  • insufficiency.
  • Adrenal hyperplasia is identified when adrenal
  • limbs measure greater than 10 mm in thickness and may or may not be hormonally
    functioning.
  • Nonhemorrhagic adrenal infarction appears as a
  • nonenhancing, edematous adrenal gland with surrounding stranding and restricted
    diffusion.
  • Adrenal infarction can be seen in
  • hypercoagulable states, antiphospholipid-antibody syndrome and pregnancy.

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    Radiology Lectures | RadquartersBy Daniel J. Kowal, MD

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