Adrenal Gland MRI Scan: Complete Guide

An adrenal gland MRI is a specialised imaging study of the two small adrenal glands that sit on top of each kidney. These glands produce critical hormones including cortisol, aldosterone, and adrenaline. MRI is particularly useful for characterising adrenal masses — distinguishing benign adenomas from more concerning lesions — thanks to its superior soft-tissue contrast and specific sequences that detect fat and other tissue characteristics. This guide explains what you need to know about adrenal MRI in the UK.

What an Adrenal Gland MRI Shows

Adrenal MRI can detect and characterise:

• Adrenal adenomas — the most common adrenal mass, usually benign. MRI can identify intracellular lipid (fat) content, which is characteristic of adenomas
• Phaeochromocytoma — a rare adrenaline-producing tumour causing episodic hypertension, headaches, and sweating
• Adrenal metastases — secondary cancer spread to the adrenals, particularly from lung, breast, or kidney cancer
• Adrenocortical carcinoma — a rare primary adrenal cancer
• Adrenal hyperplasia — bilateral enlargement of the adrenal glands, often related to excess ACTH stimulation
• Myelolipoma — a benign fat-containing adrenal tumour with characteristic MRI appearance
• Adrenal cysts — fluid-filled lesions that are almost always benign
• Adrenal haemorrhage — bleeding into the adrenal gland, which can occur in trauma, anticoagulation, or sepsis

When You Might Need an Adrenal Gland MRI

An adrenal MRI is typically requested when:

• An adrenal mass (incidentaloma) has been found on CT or ultrasound and needs further characterisation
• Hormonal blood tests suggest an adrenal tumour (e.g. elevated cortisol, aldosterone, or catecholamines)
• You have symptoms of phaeochromocytoma — episodes of high blood pressure, headaches, sweating, and rapid heartbeat
• Cushing's syndrome is suspected and CT hasn't provided a clear answer
• You have a known cancer and adrenal metastases need to be confirmed or excluded
• Monitoring a known adrenal mass over time
• Investigation of resistant hypertension (high blood pressure not responding to multiple medications)

How to Prepare for an Adrenal Gland MRI

• Fasting: You may be asked to fast for 4–6 hours, especially if contrast is being used
• Medications: Continue your usual medications unless your endocrinologist advises otherwise. This is particularly important if you're on steroid replacement
• Contrast: Gadolinium contrast is usually administered for adrenal characterisation
• Clothing: Wear comfortable clothes without metal
• Medical history: Inform the team about kidney function, allergies, and any implants

What to Expect During the Scan

An adrenal gland MRI typically takes 30–45 minutes:

1. Positioning: You'll lie on your back with a coil placed over your upper abdomen
2. Chemical shift imaging: Special "in-phase" and "opposed-phase" sequences are acquired — these detect intracellular fat, which is the key distinguishing feature of adrenal adenomas
3. Contrast injection: Gadolinium is injected for enhancement patterns
4. Breath-holds: You'll be asked to hold your breath several times to reduce motion
5. Multi-plane imaging: Images in multiple orientations provide full assessment
6. Completion: You can eat and drink normally afterwards

Adrenal Gland MRI Cost in the UK

A private adrenal MRI in the UK typically costs between £400 and £800. This usually includes contrast and specialist reporting.

Lola Health offers adrenal gland MRI scans through 150+ UK scanning centres. Results are reported by a specialist radiologist within 7–10 working days. View our adrenal gland MRI scan for pricing and booking.

Adrenal Gland MRI and Blood Testing

Blood tests are essential for evaluating adrenal gland function and are often what triggers an adrenal MRI. Key tests include:

• Cortisol (morning or dexamethasone suppression test) — elevated in Cushing's syndrome, which may be caused by an adrenal adenoma
• ACTH — helps distinguish adrenal Cushing's (low ACTH) from pituitary Cushing's (high ACTH)
• Aldosterone and renin — an elevated aldosterone-to-renin ratio suggests Conn's syndrome (aldosterone-producing adrenal adenoma), a treatable cause of hypertension
• Plasma metanephrines or 24-hour urinary catecholamines — the key screening tests for phaeochromocytoma
• DHEA-S (dehydroepiandrosterone sulphate) — elevated in adrenocortical carcinoma or congenital adrenal hyperplasia
• Electrolytes (potassium, sodium) — low potassium with high blood pressure is a classic sign of hyperaldosteronism

Start with a Lola Health blood test to check your cortisol (morning), DHEA-S, aldosterone, and renin. If results suggest further investigation, a adrenal gland MRI can provide the structural detail your blood results can't show. Peak Insights 70 covers these markers across 70 biomarkers.

The combination of hormonal blood results and MRI findings is important for accurate diagnosis and treatment planning in adrenal disease.

Explore Lola Health blood tests for adrenal and hormonal panels.

Considering a broader check? Read our full body MRI scan guide to see what a complete MRI screening covers, or explore the Peak 70 + Full Body MRI bundle for the most thorough health check available.

Frequently Asked Questions

What is an adrenal incidentaloma?

It's an adrenal mass found unexpectedly on imaging done for another reason. Incidentalomas are very common — found in about 4–5% of abdominal CT scans. Most are benign adenomas, but they need further investigation with MRI and blood tests.

Can adrenal MRI tell if a mass is cancerous?

MRI is excellent at distinguishing benign adenomas from potentially malignant lesions. Features like size (>4 cm), irregular margins, and specific signal characteristics help guide the diagnosis.

How long does the scan take?

Typically 30–45 minutes.

Is the scan painful?

No. The only minor discomfort is the cannula insertion for contrast.

Can I have an adrenal MRI without a referral?

For a private adrenal MRI through Lola Health, a referral isn't mandatory. However, adrenal imaging is most useful when interpreted alongside hormonal blood test results.

How often should adrenal masses be monitored?

For small, benign-appearing incidentalomas, guidelines typically recommend repeat imaging at 6–12 months, then again at 24 months. Your endocrinologist will advise on the appropriate interval.

Book Your Adrenal Gland MRI Scan

If you need further investigation of an adrenal mass, hormonal imbalance, or resistant hypertension, an adrenal gland MRI provides the detailed imaging needed for diagnosis.