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PURPOSE: To determine whether adrenal adenomas can be differentiated from metastases on fat-saturated magnetic resonance (MR) images. MATERIALS AND METHODS: Twenty-eight adrenal adenomas and 20 metastatic lesions were imaged at 1.5 T by means of fat-saturated T1- and T2-weighted and gadolinium-enhanced T1-weighted sequences. The authors evaluated visually whether structures of high signal intensity (hyperintense rim sign) could be observed in the outer margin of the adrenal masses. RESULTS: Twenty-six of 28 adrenal adenomas revealed the hyperintense rim sign on at least one kind of fat-saturated image, compared with only one of 20 metastases. The sensitivity of the hyperintense rim sign as suggestive of adrenal adenoma was 92%, specificity was 95%, and overall accuracy was 94%. CONCLUSION: The hyperintense rim sign is characteristic of adrenal adenomas. Thus, adrenal adenomas can be differentiated from metastases by means of this new imaging sign on fat-saturated MR images.

PURPOSE: To determine whether decreased signal intensity of the motor cortex (T2 shortening) at magnetic resonance (MR) imaging is a useful finding for supporting the diagnosis of amyotrophic lateral sclerosis (ALS). MATERIALS AND METHODS: High-field-strength (1.5-T) MR images of 15 patients (seven men and eight women, aged 28-80 years) and 49 neurologically normal age-matched control patients were examined for T2 shortening in the motor cortex. In addition, brains of patients with ALS were examined at autopsy. RESULTS: The MR images of 14 of the 15 patients showed T2 shortening in precentral cortices, while the images of all but one of the control patients showed no such finding. In three of eight brains at autopsy, sections from the precentral cortex showed sparsely distributed, intensely stained astrocytes and macrophages. CONCLUSION: Abnormal iron deposition associated with the degenerative process could be the source of T2 shortening, which is a useful MR imaging finding in the diagnosis of ALS.