Current imaging techniques permit the adrenal gland to be visualized with superb clarity and spatial resolution. Except in rare circumstances, other methods of adrenal imaging have been supplanted by computed tomography (CT) and magnetic resonance imaging (MRI).

CT should be the initial study for adrenal imaging in virtually all patients. It is capable of demonstrating the adrenal glands in virtually 100% of normal individuals. It provides greater spatial resolution than MRI and is less expensive. Ultrasonography costs less than CT, but it is operator dependent, has a high false-negative rate, and is often unable to permit imaging of the left adrenal gland. CT is more accurate than ultra-sonography and can demonstrate both normal adrenal glands in virtually all patients (Fig. 88-1). MRI is more helpful for differential diagnosis of a known adrenal mass, but CT is a more appropriate screening technique. Oral and intravenous contrast materials are not normally required but can be helpful in some very thin patients.