Diffusion-weighted MRI in the characterization of adrenal masses

Background The adrenal gland is associated with various pathological conditions, which include hemorrhage, hyperplasia, and both benign and malignant tumors. Numerous investigations have differentiated malignant from benign adrenal tumors through various imaging techniques, focusing on the existence of fat, computed tomography washout characteristics, or positron emission tomography attributes. Aim To evaluate the impact of diffusion-weighted imaging in the differentiation of adrenal masses. Patients and methods This work was conducted on 46 participants (18 men and 28 women) aged from 16 to 66 years with adrenal masses. Results In the present study, there were 15 cases with lipid-rich adenoma, eight cases with lipid-poor adenoma, nine cases with metastases, four cases with adrenocortical carcinoma, three cases with cyst, three cases with pheochromocytoma, three cases with myelolipoma, and a case had ganglioneuroma. The mean apparent diffusion coefficient in benign tumors was 1.3 ± 0.233 while in the malignant lesions it was 0.9 ± 0.467 with a high statistically significant variation between ( P <0.001). Conclusion The size of the lesion and the signal drop were more robust indicators of adrenal malignancies than the apparent diffusion coefficient.