Adrenal Hemorrhage

In this video lecture, we discuss the imaging appearance of adrenal hemorrhage on CT, MRI and ultrasound. Causes of adrenal hemorrhage will also be reviewed. 

Key points include:

  • On CT scan, adrenal hemorrhage typically appears as a nonenhancing round or oval hyperdense mass with density of 50-90 HU. 
  • MRI is the most sensitive and specific modality for diagnosing adrenal hemorrhage. 
  • The “high signal intensity rim” rim sign seen on T1-weighted images is characteristic of subacute adrenal hemorrhage. 
  • Adrenal hemorrhage may appear solid or cystic on ultrasound depending on the age of hemorrhage.
  • Adrenal hemorrhage is more common in neonates than in children and adults and is the most common adrenal mass in infancy.
  • Trauma is the most common cause and is usually unilateral and right-sided. 
  • Atraumatic adrenal hemorrhage is usually unilateral.