CT of adrenal incidentalomas
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Author:
Mikael Häggström [notes 1]
Evaluation
Measure:
- Size
- Attenuation
- Heterogeneity[1]
Further workup
Adrenal masses discovered incidentally ("incidentalomas") have the following workup by Swedish national guidelines:[2]
| Features | Workup | ||
|---|---|---|---|
| Size < 1 cm | No radiologic workup needed (but biochemical screening may be indicated if clinical suspicion of being hormonally active) | ||
| Size 1 to 4 cm | Attenuation ≤10 HU (adenoma) | ||
| Attenuation >10 HU | Without IV contrast | CT after 6 months, then stop if size is unchanged | |
| On contrast CT | CT without contrast as either:
| ||
Report
- Size
- Attenuation. The attenuation value only needs to be reported as relative to the 10 HU threshold, such as "well below 10 HU" or "slightly below 10 HU".
- Heterogeneity only if clearly present.[notes 2]
- Optionally, a recommendation for further workup if applicable.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
- ↑ Heterogeneity is a fairly specific but unacceptably non-sensitive finding of malignant tumors.
- Tu, Wendy; Verma, Raman; Krishna, Satheesh; McInnes, Matthew D. F.; Flood, Trevor A.; Schieda, Nicola (2018). "Can Adrenal Adenomas Be Differentiated From Adrenal Metastases at Single-Phase Contrast-Enhanced CT? ". American Journal of Roentgenology 211 (5): 1044–1050. doi:. ISSN 0361-803X.
References
- ↑ Tu, Wendy; Verma, Raman; Krishna, Satheesh; McInnes, Matthew D. F.; Flood, Trevor A.; Schieda, Nicola (2018). "Can Adrenal Adenomas Be Differentiated From Adrenal Metastases at Single-Phase Contrast-Enhanced CT? ". American Journal of Roentgenology 211 (5): 1044–1050. doi:. ISSN 0361-803X.
- ↑ . Utredning av binjureincidentalom (Workup of adrenal incidentalomas). Swedish Society of Radiology.
