Utility of chemical shift and diffusion-weighted imaging in characterization of hyperattenuating adrenal lesions at 3.0T

Abstract

Objective: The purpose of our study was to evaluate the value of chemical shift imaging (CSI) and diffusion weighted imaging (DWI) at 3.0 T MRI in adrenal hyperattenuating lesions.

Methods: Fifty-one hyperattenuating adrenal lesions in 40 patients were evaluated. Signal intensity index (SII), adrenal to spleen ratio (ASR) and apparent diffusion coefficient (ADC) were used as quantitative analysis parameters.

Results: The mean SII, ASR and ADC values were: benign pheochromocytomas (n=22), 7.04%; 0.96, 1.15×10(-3) mm(2)/s; lipid-poor adenomas (n=18), 33.77%, 0.71, 1.07×10(-3) mm(2)/s; malignant tumors (n=7), 11.24%; 1.00; 0.92×10(-3) mm(2)/s. There were significant differences between the lipid-poor adenomas and nonadenomas for SII and ASR, and there were significant differences between the benign and the malignant tumor ADC values. The optimal diagnostic threshold point of SII and ASR for lipid-poor adenomas was 11.96%, 0.83, the sensitivity and specificity were 88.9%, 97.5% and 97%, 83.3%. The optimal diagnostic threshold point of ADC value for benign lesions and malignant tumors was 1.04×10(-3) mm(2)/s, the sensitivity and specificity were 61.4% and 85.7%.

Conclusion: Quantitative analysis of chemical shift MRI and DWI can help to characterize the hyperattenuating adrenal lesions, especially in differentiatiation between the lipid-poor adenomas, the benign pheochromocytomas, and the malignant tumors.