CT and MR imaging of the adrenal glands in ACTH-independent cushing syndrome

Share this:
Cite this:

Diaz-Cano, Salvador J.; Grossman, A B; Babar, S A; Sohaib, S A A; Monson, J P; Isidori, A M; Reznek, R H; Rockall, A G (2012): CT and MR imaging of the adrenal glands in ACTH-independent cushing syndrome. figshare.

Retrieved 18:26, Nov 28, 2015 (GMT)


Adrenocorticotropic hormone (ACTH)-independent hypercortisolism accounts for 15%-20% of cases of Cushing syndrome and always arises from primary adrenal disease. Computed tomographic (CT) and magnetic resonance (MR) imaging findings in 37 patients with primary adrenal Cushing syndrome were analyzed and correlated with pathologic findings. Hyperfunctioning adenomas (n = 24), together with functioning carcinomas (n = 10), accounted for 92% of cases. Adenomas had a significantly smaller mean size (3.5 vs 14.5 cm) and lower mean unenhanced CT attenuation value (11 vs 28 HU) than did carcinomas. The presence of necrosis, hemorrhage, and calcification favored a diagnosis of carcinoma. Six of 10 carcinoma patients had metastases at presentation. Two adenomas were seen within a myelolipoma, which was recognized at both CT and MR imaging due to its fat content, and two adenomas were of uncertain malignant potential. Bilateral disease--primary pigmented nodular adrenal dysplasia (PPNAD) (n = 2) and ACTH-independent macronodular adrenal hyperplasia (AIMAH) (n = 1)--had characteristic imaging features. In PPNAD, multiple tiny (2-5-mm) nodules were visible bilaterally, with no overall glandular enlargement and normal intervening adrenal tissue. In AIMAH, both glands were grossly enlarged and contained nodules up to 3 cm in diameter. Familiarity with the range of imaging appearances of the adrenal glands in primary adrenal Cushing syndrome may help establish the underlying diagnosis.


Comments (0)

You must be logged in to post comments.



Published on 18 Nov 2012 - 17:55 (GMT)

Filesize is 3.20 MB



  • Salvador J. Diaz-Cano
  • A B Grossman
  • S A Babar
  • S A A Sohaib
  • J P Monson
  • A M Isidori
  • R H Reznek
  • A G Rockall


License (what's this?)



Cite "Filename"

Place your mouse over the citation text to select it

Embed "CT and MR imaging of the adrenal glands in ACTH-independent cushing syndrome"

Place your mouse over the embed code to select and copy it

Claim article

You claim request was sent. I will be handled in the next 24 hours.

Close window


We appreciate all your comments, questions, suggestions or gratitude.


The username or password entered are wrong.

Reset password

Your password will be sent to your registered e-mail address.

Create account

I agree to the Terms & Conditions *