Difference between revisions of "CT of adrenal incidentalomas"
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[[File:CT of adrenal adenoma.jpg|thumb|Axial slice of CT without contrast, showing an adenoma. It has low attenuation, and well-defined margins.]] | [[File:CT of adrenal adenoma.jpg|thumb|Axial slice of CT without contrast, showing an adenoma. It has low attenuation, and well-defined margins.]] | ||
| − | == | + | ==Evaluation== |
| + | Measure: | ||
| + | *Size | ||
| + | *Attenuation | ||
| + | *Heterogeneity<ref name="TuVerma2018">{{cite journal|last1=Tu|first1=Wendy|last2=Verma|first2=Raman|last3=Krishna|first3=Satheesh|last4=McInnes|first4=Matthew D. F.|last5=Flood|first5=Trevor A.|last6=Schieda|first6=Nicola|title=Can Adrenal Adenomas Be Differentiated From Adrenal Metastases at Single-Phase Contrast-Enhanced CT?|journal=American Journal of Roentgenology|volume=211|issue=5|year=2018|pages=1044–1050|issn=0361-803X|doi=10.2214/AJR.17.19276}}</ref> | ||
| + | |||
| + | ==Further workup== | ||
Adrenal masses discovered incidentally ("incidentalomas") have the following workup by Swedish national guidelines:<ref>{{cite web|url=http://www.sfmr.se/sidor/utredning-av-binjureincidentalom/|title=Utredning av binjureincidentalom (Workup of adrenal incidentalomas)|website=Swedish Society of Radiology}}</ref> | Adrenal masses discovered incidentally ("incidentalomas") have the following workup by Swedish national guidelines:<ref>{{cite web|url=http://www.sfmr.se/sidor/utredning-av-binjureincidentalom/|title=Utredning av binjureincidentalom (Workup of adrenal incidentalomas)|website=Swedish Society of Radiology}}</ref> | ||
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*After 6 months for size control | *After 6 months for size control | ||
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| + | ==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". | ||
| + | *Optionally, a recommendation for further workup if applicable. | ||
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Revision as of 08:41, 2 August 2019
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".
- 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.
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.
