IMAGING OF ADRENAL INCIDENTALOMAS

Imaging plays an important role in evaluating fortuitously discovered adrenal masses. These unanticipated masses (incidentalomas) are usuall y discovered at CT examinations. Although most incidentally discovered adrenal tumors are nonhyperfunctioning adenomas, they must be disting uished from primary or secondary malignant lesions. Recent studies hav e established that both unenhanced CT scans and chemical shift MR imag ing can accurately differentiate benign adenomas from nonadenomatous m asses by features that reflect the large amount of lipid found in most adenomas and absent in most nonadenomas. We review here the current i maging issues concerning adrenal incidentalomas including diagnostic a pproaches and management.