Abstract
Introduction: Pheochromocytomas are chromaffin cell tumours derived from the neural crest and they are associated with catecholamine production. Radiological procedures are playing essential role in present diagnostic of adrenal glands. Physicians who send their patients to the radiological examinations should prepare them to have a safe further diagnostic. Aa well radiologist should be aware of scanning protocols to provide best quality and the safest for the patient radiological examination.Aim of the study: This article summarizes the current knowledge about radiological imaging of pheochromocytomas and scan procedures. In this paper we also want to answer to the question does a patient with pheochromocytoma need to be specially prepared for radiological procedures.Description of knowledge: Diagnostic procedures play primary role in present diagnostic and treatment of pheochomocytomas. It is crucial for further diagnostic procedures to locate the tumour and its margins.Ultrasound imaging can be used with success only in big tumours with clinical symptoms. First choice for adrenal gland tumours is always CT. That modality easily shows localisation and tumours smaller than 1 cm. Another method of choice for adrenal imaging is MRI which gives high contrast images between soft tissues. Radiological differentiation of lessions wouldn’t be possible without contrast agents. They are crucial for calculations of washout in CT.Conclusions: Intravenous administration of non-ionic contrast agent for CT and gadolinium based in MRI is a safe practice for patients with pheos even without α-blocking medication. Only in an intra-arterial iodine-based contrast administration patient should be pharmacologically prepared before examination.
Highlights
Pheochromocytomas are chromaffin cell tumours derived from the neural crest and they are associated with catecholamine production[1]
Pheos in CT imaging are often well-defined masses with attenuation values like those of muscle tissue, measuring approximately 30–40 HU24 but it can be less than 10 HU and the tumour may display more than 60% washout of contrast agents on delayed scanning
The main question is can we administer a contrast agent to a patient during CT or MRI after non-contrast-enhanced phase if we have a doubt, we have found an incidentaloma that could be a pheo? According to the latest ESUR Guidelines there is no need of special preparation for intravenous iodine- or gadolinium-based contrast agent in CT or MRI
Summary
Intravenous administration of non-ionic contrast agent for CT and gadolinium based in MRI is a safe practice for patients with pheos even without α-blocking medication. Radiological imaging can be a useful tool in diagnosing multiple primary tumours or metastatic lesions in patients with various genetic disorders[20]. Pheos in CT imaging are often well-defined masses with attenuation values like those of muscle tissue, measuring approximately 30–40 HU24 but it can be less than 10 HU and the tumour may display more than 60% washout of contrast agents on delayed scanning. According to the latest ESUR Guidelines there is no need of special preparation for intravenous iodine- or gadolinium-based contrast agent in CT or MRI. Otherwise is recommended in examinations which require intra-arterial iodine-based contrast medium – in that case we have to orally administer drugs to block α and β-adrenergic receptors[28]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
