Adrenal masses: characterization with combined unenhanced and delayed enhanced CT

Radiology. 2002 Mar;222(3):629-33. doi: 10.1148/radiol.2223010766.


Purpose: To assess the accuracy of a dedicated adrenal computed tomographic (CT) protocol.

Materials and methods: One hundred sixty-six adrenal masses were evaluated with a protocol consisting of unenhanced CT, and, for those with attenuation values greater than 10 HU, contrast material-enhanced and delayed enhanced CT. Attenuation values and enhancement washout calculations were obtained. An adenoma was diagnosed if a mass had an attenuation value of 10 HU or less at unenhanced CT or a percentage enhancement washout value of 60% or higher.

Results: The final diagnosis was adenoma in 127 masses and non-adenoma in 39. Masses measuring more than 10 HU on unenhanced CT scans were confirmed at biopsy (n = 28) or were examined for stability or change in size at follow-up CT performed at a minimum interval of 6 months (n = 33). Thirty-six (92%) of 39 non-adenomas and 124 (98%) of 127 adenomas were correctly characterized. The sensitivity and specificity of this protocol were 98% and 92%, respectively. This protocol correctly characterized 160 (96%) of 166 masses.

Conclusion: With a combination of unenhanced and delayed enhanced CT, nearly all adrenal masses can be correctly categorized as adenomas or non-adenomas.

MeSH terms

  • Adenoma / diagnostic imaging
  • Adrenal Gland Neoplasms / diagnostic imaging*
  • Adrenal Glands / diagnostic imaging
  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media*
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Radiographic Image Enhancement*
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*


  • Contrast Media