Ultrasonography of adrenal glands



Year of publication 2016
Type Article in Periodical
MU Faculty or unit

Faculty of Medicine

Field Endocrinology, diabetology, metabolism, nutrition
Keywords ultrasonography, adrenal glands, adenoma, incidentaloma
Description Ultrasonography of adrenal glands Objectives The role of ultrasound in diagnosis of adrenal enlargement. Introduction The adrenal glands are located in the retroperitoneum and belong among paired organs with endocrine function. They are composed of cortex producing steroid hormones and medulla secreting catecholamines. The adrenal glands are located in the perirenal space, craniomedial to the upper poles of the kidneys. Ultrasonography of adrenal glands In adults, we perform transabdominal ultrasohography using convex probe and we scan the adrenal glands in various planes. It is advantageous to use the liver, spleen or kidney as an acoustic window and to use harmonic imaging. Visualization of the adrenal glands is often difficult and requires an experienced operator. Major limitations are body habitus and excessive bowel gas. Adrenal glands are more accessible in newborns as their size is proportionately larger. According to some authors the detection of the right adrenal gland is possible in 78,5% and the left adrenal gland in 44% Incidentaloma is an asymptomatic tumor incidentally detected by imaging modality performed for an unrelated reason. It is always necessary to rule out malignancy and to assess the secretory activity of a mass. In published work, the incidence of incidentalomas has been quoted between 0,5 and 5% for CT examination, the detection of incidentalomas during ultrasound examination is even rarer. Conclusion Ultrasonography is not a suitable method for a targeted review of adrenal gland area, there are several factors which reduce the sensitivity, such as extensive bowel gas or obesity. We cannot determine the biological nature of a mass only on the basis of ultrasound examination. We should be especially careful when evaluating adrenal masses in oncological patients. Contrast enhanced ultrasonography can help distinguish between solid and cystic lesions.
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