About an adrenal gland MRI scan
You have two adrenal glands, one sitting on top of each kidney. Although they are small, they make important hormones, including cortisol (which helps control blood sugar, blood pressure and the response to stress), aldosterone (which helps control salt, potassium and blood pressure) and adrenaline.
An MRI scan uses a strong magnetic field and radio waves, not X-rays, to make detailed pictures of the adrenal glands and the tissues around them. It is most often requested to look more closely at a lump on an adrenal gland, sometimes called an adrenal “incidentaloma” when it has been found by chance on a scan done for another reason. These lumps are common: they are found in around 3% of people over 50 and more than 7% of people over 70, and most are harmless.
A special MRI technique called chemical shift imaging can detect the tiny amounts of fat inside the most common type of harmless adrenal lump (an adenoma), which helps the radiologist tell it apart from other types of growth. MRI also avoids radiation, which can make it a good choice when repeat scans are needed to check whether a lump has changed.
What happens during the scan
You lie on your back on a padded bed that slides into the scanner, with a coil placed over your tummy. The scanner is loud, so you will wear ear plugs or headphones. You will be asked to hold your breath for short periods, usually 15–20 seconds at a time, so that breathing movement does not blur the pictures. Some adrenal scans include an injection of contrast dye (gadolinium); where contrast is needed, it is charged separately.
What the scan can show
An adrenal MRI can help to:
- find out more about an adrenal lump seen on a CT or ultrasound scan
- identify a lipid-rich adenoma, the most common non-cancerous adrenal growth
- show other types of adrenal lump, such as myelolipomas (which contain fat), cysts and bleeding into the gland
- look for a cause when blood or urine tests show the adrenal glands may be making too much hormone, for example in high blood pressure with low potassium (too much aldosterone) or Cushing’s syndrome (too much cortisol)
- look at adrenal tumours such as phaeochromocytoma, and check whether a cancer elsewhere in the body has spread to the adrenal glands
- check whether a known lump has grown, without radiation
Hormone problems are diagnosed with blood and urine tests as well as imaging, so your doctor will usually look at the scan alongside those results.
Preparing for your scan
You may be asked not to eat for a few hours before the scan, as an empty stomach can give clearer pictures of the upper tummy. The scanning centre will confirm this when you book. If you have a previous CT or ultrasound report showing an adrenal lump, bring it with you or upload it when you book, so the radiologist can compare the scans.
You can usually eat, drink and take your normal medicines unless the scanning centre tells you otherwise. Wear loose, comfortable clothing without metal zips or buttons, and leave jewellery at home. You will be asked to remove metal items such as hair clips, hearing aids, coins and keys, and you may be asked to change into a gown.
Before the scan you will complete a safety questionnaire. Tell the team if you have a pacemaker, any metal implant, surgical clips or other device, if you have kidney problems or allergies, or if you are, or might be, pregnant or breastfeeding. If you feel anxious in enclosed spaces, let us know when you book. Some centres can offer a relaxant, and if you take one you will need someone to take you home and must not drive for 24 hours.
Frequently asked questions
Is an adrenal lump usually cancer?
No. Most adrenal lumps found by chance are harmless adenomas, and many do not make any hormones. An MRI, together with blood and urine tests, helps your doctor decide whether any further tests or treatment are needed.
Why would I have an MRI if I have already had a CT scan?
If the CT scan does not show clearly what kind of lump it is, MRI can add information. Chemical shift MRI can detect the small amount of fat found in common harmless adenomas, and MRI does not use radiation, which is helpful if the lump needs to be checked again later.
Will I need to hold my breath?
Yes, for short periods. The adrenal glands move as you breathe, so the radiographer will ask you to hold your breath for about 15–20 seconds at a time while some pictures are taken.
Will I need a contrast injection?
Not always. It depends on what your doctor is looking for. If contrast is needed, it is given through a small cannula in your arm and is charged separately.
Sources
- Cuthbertson D.J. et al. – Investigation and assessment of adrenal incidentalomas (Clinical Medicine, 2024)
- Endocrine Society – Adrenal incidentaloma
- American Cancer Society – Signs and symptoms of adrenal cancer
- RadiologyInfo.org – MRI of the Body (Chest, Abdomen, Pelvis)
- NHS – MRI scan
The information on this page has been gathered from various sources and is provided for general information only. It is not medical advice. TOP MRI is not liable for the accuracy or completeness of this information. Please speak to your doctor or the scanning centre about your own situation.