Adrenal adenomas: Relationship between histologic lipid and CT and MR findings

PURPOSE: To assess the relationship between the quantity of lipid in resected adrenal adenomas and the unenhanced computed tomographic (CT) attenuation number and the relative change in signal intensity on chemical shift magnetic resonance (MR) images. MATERIALS AND METHODS: The percentage of lipid-rich cortical cells in histologic sections from 20 resected adrenal adenomas was assessed. The results were correlated with the corresponding unenhanced CT attenuation number or the relative change in signal intensity on chemical shift MR images, or both. RESULTS: There was an inverse linear relationship between the percentage of lipid-rich cortical cells in the adrenal adenomas and the unenhanced CT attenuation number (R² = .68, P = .0005). There was a similar inverse linear relationship to the relative change in MR signal intensity on chemical shift images by using both quantitative (R² = .83, P = .004) and qualitative (R² = .70, P = .019) assessment. CONCLUSION: The presence and amount of histologic lipid in many adrenal adenomas accounts for their low attenuation on unenhanced CT scans and their loss in relative signal intensity on chemical shift MR images.