What is the role of MRI for the detection of pheochromocytoma?

Updated: Aug 10, 2018
  • Author: Michael A Blake, MBBCh, MRCPI, FRCR; Chief Editor: George T Griffing, MD  more...
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Answer

MRI is preferred for detection of pheochromocytoma in children and in pregnant or lactating women. MRI has a reported sensitivity of up to 100% in detecting adrenal pheochromocytomas, does not require contrast, and does not expose the patient to ionizing radiation. MRI is also superior to CT scanning for detecting extra-adrenal pheochromocytomas.

In approximately 70% of cases, pheochromocytomas appear hyperintense on T2-weighted images (as demonstrated in the image below), because of their high water content. [46]

Axial, T2-weighted magnetic resonance imaging (MRI Axial, T2-weighted magnetic resonance imaging (MRI) scan showing large left suprarenal mass of high signal intensity on a T2-weighted image. The mass is a pheochromocytoma.

Initial studies have suggested that MR spectroscopy can be used to distinguish pheochromocytomas from other adrenal masses. [47, 48]  Specifically, a resonance signature of 6.8 ppm appears to be unique to pheochromocytomas; the signature apparently is attributable to the catecholamines and catecholamine metabolites present in pheochromocytomas. [48]


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