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Adrenal Mass–CT/MRI

  Incidental Adrenal Masses


The guidance applies to patients who are adults (>=18 years of age), asymptomatic, and referred to imaging for a reason that is unrelated to potential adrenal pathology.
Incidental adrenal masses are common, estimated to occur in approximately 3% to 7% of adults.
In general, an incidental adrenal mass that is <1 cm needs no further work-up or follow-up.


Is this a diagnostic adrenal protocol CT exam or other type of CT or MRI exam?


Adrenal protocol CT exam.            

Other type of CT or MRI exam.



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Adrenal protocol CT consists of an unenhanced CT acquisition through the upper abdomen, which is reviewed in real time by the covering radiologist. If there are not benign diagnostic imaging features (macroscopic fat or density <=10 HU), dynamic contrast-enhanced CT (60-90 seconds after the administration of IV contrast by power injector) and a 15-min delayed acquisition are performed. Unenhanced CT should use a reduced dose technique, including tube-current modulation with limited z-axis coverage of the adrenal glands(rather than the entire abdomen). The guidance suggests using 120 kVp technique without tube-voltage modulation. Recommended collimation is 3 mm, with reconstructions in the axial and coronal planes.