Adrenal myelolipoma - MRI

Case contributed by Dr Dalia Ibrahim

Presentation

Abdominal pain and an adrenal mass on ultrasound exam.

Patient Data

Age: 50 years
Gender: Female
MRI

Right adrenal large well-defined soft tissue mass lesion eliciting high signal on T2 WI with partial signal suppression on fat saturation and out-of phase sequences. No diffusion restriction or postcontrast enhancement of the mass.

CT

Right adrenal large mass of predominant macroscopic fat-density, confirming the diagnosis of adrenal myelolipoma.

Case Discussion

CT appearance of adrenal myelolipoma is usually characteristic of fat-containing lesion, however, MRI features may be somewhat confusing.

MRI features of adrenal myelolipoma include:

  • T1: typically hyperintense due to fat contents
  • T1 (FS): shows fat suppression
  • T2: generally intermediate to hyperintense but can sometimes vary depending on contents (especially blood products) 
  • T1 C+ (Gd): shows striking enhancement 1
  • in and out of phase: in masses with mixed components, out of phase imaging may demonstrate signal loss as the microscopic fat cells usually have little intracellular water
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Case information

rID: 83249
Published: 17th Oct 2020
Last edited: 4th Nov 2020
Inclusion in quiz mode: Included