الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Incidental adrenal lesions detected on cross sectional imaging are a common clinical scenario, seen approximately 5% of all abdominal examinations. Differentiation between adenomatous and non-adenomatous lesions, particularly the malignant lesions, is important to predict prognosis of the primary disease, to assess staging and direct therapy, and to preclude the need for both percutaneous biopsy and follow-up imaging in these patients. The purpose of this study was to evaluate value of the multiparametric MRI including Chemical shift imaging, diffusion weighted and dynamic contrast MR imaging for the differentiation of adrenal adenomas from malignant adrenal tumors. Between April 2018 to July 2022, 40 patients with 42 adrenal lesions (14 adenomas, 8 metastases, 8 adrenal cortical carcinomas 5 pheochromocytoma) underwent multiparametric MRI including Chemical shift imaging, diffusion weighted and dynamic contrast MR imaging. CSI was assessed qualitatively and by calculating the adrenal signal intensity index, and enhancement patterns were evaluated qualitatively and quantitatively. Statistical analyses were performed. Most of adenomas revealed iso to low signal intensity on T2 images, while non adenomas exhibited heterogeneous high T2 signal intensity because underlying hemorrhage and degeneration. A significant signal DROP on CSI was seen in most of adenomas. Adrenal signal intensity index was calculated with a cut off value of 23%, Area under the curve was 0.954 (P=0.001, the sensitivity was 92% and specificity was 78 %. Diffusion weighted images and Apparent Diffusion Coefficient could not show significant statistical difference between both groups. Diffusion tensor imaging and FA could differentiated between both groups with a cut off value of 0.34.