Primary hyperaldosteronism MRI Findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Adrenal MRI may be helpful in the diagnosis of primary hyperaldosteronism when the attenuation on CT is <30 HU.

Chemical shift imaging on MRI is the most reliable for diagnosis especially when CT findings are unrewarding.^[1]^[2]
MRI is useful for adrenal masses with a signal intensity <30 HU.
Signal dropout on out-of-phase imaging for:
- 10-30 HU on CT is 89% sensitive and 100% specific
- 10-20 HU on CT is 100% sensitive and 100% specific
- Sensitivity of 70 to 100% in detecting APA, depending on the size of the lesion, being greatest for lesions > 2 cm.
- Limitations are similar to that of CT scan.

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↑ Ctvrtlik F, Koranda P, Tichy T (2014). "Adrenal disease: a clinical update and overview of imaging. A review". Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 158 (1): 23–34. doi:10.5507/bp.2014.010. PMID 24621966.
↑ Lim V, Guo Q, Grant CS, Thompson GB, Richards ML, Farley DR, Young WF (2014). "Accuracy of adrenal imaging and adrenal venous sampling in predicting surgical cure of primary aldosteronism". J. Clin. Endocrinol. Metab. 99 (8): 2712–9. doi:10.1210/jc.2013-4146. PMID 24796926.