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MRI adrenal glands without contrast (in-phase and out of phase scanning)

What is an MRI of the Adrenal Glands Without Contrast (In-Phase and Out-of-Phase Scanning)?

An MRI of the adrenal glands without contrast is a specialized imaging test used to evaluate the adrenal glands, which are small glands located on top of each kidney. It is particularly useful for assessing adrenal masses, hormonal imbalances, and abnormalities in the structure or function of the adrenal glands.

The use of in-phase and out-of-phase imaging allows radiologists to better characterize tissue types, particularly for identifying fat within adrenal masses, which can help differentiate between benign and malignant conditions.

In-Phase and Out-of-Phase Scanning

  • In-Phase Imaging: Captures the MRI signal when the fat and water molecules in tissues are synchronized. This helps create a baseline image.
  • Out-of-Phase Imaging: Captures the signal when the fat and water molecules are out of sync, leading to signal loss in tissues that contain both fat and water. This technique is especially useful for identifying fat in adrenal lesions, such as adrenal adenomas (benign tumors).

Why is it Done?

This test is often used to:

  • Detect and evaluate adrenal masses (e.g., adenomas, pheochromocytomas, or metastatic lesions).
  • Differentiate between benign and malignant adrenal lesions.
  • Assess adrenal gland enlargement or structural abnormalities.
  • Investigate causes of hormonal imbalances (e.g., Cushing’s syndrome, hyperaldosteronism, or pheochromocytoma).
  • Monitor known adrenal lesions over time.

What to Expect

Before the Procedure:

  • Preparation:
    • No specific preparation, such as fasting, is required.
    • Remove all metal objects, including jewelry, piercings, or clothing with metal components.
  • Medical History:
    • Inform your doctor if you have metal implants, pacemakers, or are pregnant.
  • Contrast:
    • Since no contrast is used, there’s no need to consider potential allergies or kidney function concerns.

During the Procedure:

  1. Positioning:
    • You’ll lie on a motorized table that slides into the MRI machine. Cushions may be provided for comfort.
  2. Scanning:
    • The scan includes both in-phase and out-of-phase sequences to identify the presence of fat or specific tissue characteristics in adrenal masses.
    • You’ll hear loud thumping or buzzing noises as the machine takes images.
    • You may be asked to hold your breath briefly during certain parts of the scan to improve image quality.
  3. Duration:
    • The procedure typically lasts 30–40 minutes.

After the Procedure:

  • You can resume normal activities immediately after the scan.
  • No side effects are expected since no contrast is used.

What the Results May Show:

  • Normal Results: Healthy adrenal glands with no masses or structural abnormalities.
  • Abnormal Results:
    • Adrenal Adenomas: Benign tumors that often show fat content detectable with out-of-phase imaging.
    • Pheochromocytomas: Rare tumors that may appear as solid, vascular masses.
    • Metastatic Lesions: Cancerous growths that have spread to the adrenal glands.
    • Adrenal Hyperplasia: Enlargement of the glands, often associated with hormonal overproduction.
    • Adrenal Cysts: Fluid-filled sacs.

Your doctor will explain the findings and recommend further steps, such as additional imaging or tests, if necessary.