Presentation
Abdominal pain and an adrenal mass on ultrasound exam.
Patient Data
Age: 50 years
Gender: Female
From the case:
Adrenal myelolipoma - MRI
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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.
From the case:
Adrenal myelolipoma - MRI
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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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