Diagnostic capabilities of magnetic resonance imaging in the differential diagnosis of adrenal pheochromocytoma

Introduction. Differential diagnosis of pheochromocytoma from adrenal adenoma is extremely important at the stage of planning surgical intervention. In some cases, laboratory data and computed tomography (CT) are insufficient for making an accurate diagnosis. In our study, we aimed to evaluate the possibilities of magnetic resonance imaging in the diagnosis of adrenal pheochromocytoma.

Aim. Evaluation of the possibilities of using multiparametric magnetic resonance imaging in the differential diagnostic of adrenal pheochromocytoma.

Materials and Methods. The study included 69 patients with adrenal gland tumors who underwent surgery due to the clinically malignant potential of the tumor or its hormonal activity. All patients underwent multiparametric magnetic resonance imaging. During the postprocessing, the signal intensity of the adrenal gland tumors, signal intensity indices (including in comparison with the spleen and muscles) were evaluated in various series in order to assess the differences between these indicators in pheochromocytomas and other adrenal gland tumors.

Results. Pheochromocytomas are characterized by the following thresholds: signal intensity index on T2-weighted lesion compared to the muscles (T2 index) > 2.630: signal intensity index on dual-echo series (SI index) < 16.600, chemical shift index compared to the spleen (ASR) > 0.840.

Conclusions. Each of the studied parameters had a number of exceptions and limitations, therefore, the results of this study and the proposed thresholds are necessary for confirmation in future multicenter studies that could provide a more accurate differential diagnosis of adrenal gland tumors in clinical practice.

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