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How does in- and out-of-phase imaging help in this condition?
If the lesion contains intracellular lipid it will show characteristic signal loss on out-of-phase imaging as compared to in-phase. Many adrenal myelolipomas contain macroscopic fat, however, which will fat saturate, but not become hypointense on the out of phase sequence.
The lesion follows fat signal on MRI. In and out-of-phase T1 weighted sequenced add little to this as the fat content is macroscopic.