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Imaging plays a key role in assessing the vast number of incidental adrenal lesions, the majority of which are adrenal adenomas. Correlation with previous imaging is often useful, as a lesion which has not changed over some years is unlikely to be malignant.

Case Discussion Features are characteristic of an adrenal adenoma on multiphasic CT imaging.

Adrenal adenomas can be detected on non contrast scans due to its low HU (<10 HU is highly specific). However, MRI is indicated in ambiguous lesions with higher HU corresponding to soft tissue.

Citation, DOI, disclosures and article data Gaillard F, Niknejad M, Bell D, et al. Adrenal gland tumors. Reference article, Radiopaedia.org (Accessed on 16 Jan 2026) s: doi.org 10.53347 rID 10775 At the time the article was created Frank Gaillard had no recorded disclosures.

Ultrasound imaging revealed a well defined lesion in the anticipated location of the right adrenal gland. A review of prior patient imaging, specifically lower cuts from a previous chest CT scan, confirmed the lesion's adrenal origin, with imaging findings of a lipid rich adrenal adenoma.

dedicated adrenal CT is preferred to determine if a 1 4 cm mass with density >10 HU is a benign adenoma wherever possible, the stability of a lesion should be assessed with any modality that has imaged the adrenals in the past (e.g. chest CT, PET CT, abdominal ultrasound, lumbar spine MRI)

Adrenal glands protocol is an MRI protocol comprising a group of MRI sequences put together to further assess indeterminate adrenal lesions, in particular, lipid poor adenomas. Note: This article is intended to outline some general principles of protocol design.

Adrenal lesions cover a broad spectrum from benign to neoplastic entities. Due to increased use of cross sectional imaging they are frequently detected as incidental lesions (incidentalomas).

Adrenal washout can be calculated using the density value of an adrenal mass on non enhanced, portal venous phase and 15 minute delayed CT scans (density measured in Hounsfield units (HU)).

There are numerous fat containing adrenal lesions, often benign and non functional 1. Benign lesions containing fat: adrenal myelolipoma lipid rich adrenal adenoma adrenal lipoma adrenal teratoma adrenal angiomyolipoma adrenal hibernoma Malignant lesions may also occasionally contain fat: adrenocortical carcinoma: rarely contains a fat component

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