High-resolution real-time sonography of the adrenal glands: a routine examination?

Abstract

The feasibility of imaging the adrenal glands during routine upper abdominal examinations was studied for 100 consecutive patients, 47 males and 53 females. The mean patient age was 46 years and the mean weight 63 kg. The suprarenal areas were scanned in a slightly oblique frontal plane through the intercostal spaces with the patient recumbent. The right adrenal gland was detected in 92 per cent of the patients, with a mean examination time of less than one minute. Visualization of the left adrenal gland was more difficult and was successful in only 71 per cent, even where additional views in the right lateral decubitus or erect position were added. The mean examination time on the left was 2 1/2 minutes. Complete visualization of the adrenal gland is impossible in one single plane because of the complex shape of the organ, which necessitates multiple contiguous scan planes. In 13 per cent of the visualized adrenals, cortex and medulla could be differentiated.

Adrenal Gland and Renal Sonography

“…The glands are composed of cortex and medulla. The adrenal medulla secretes catecholamines where the adrenal cortex is divided into 3 distinct zones: the zona glomerulosa, which secretes aldosterone, and the zona fasciculata and zona reticularis, which secrete cortisol and androgens [1][2][3][4].…”

Ultrasonography in the Diagnosis of Aldosterone-Producing Adenoma: Is It Useful?

“…Computed axial tomography (CT) is generally con sidered to be superior to ultrasonography (US) in the localization diagnosis of small adrenal tumors (1)(2)(3). However, in Japan, there has recently been an increase in the use of CT, so that a patient must wait one to two weeks before examination.…”

“…However, the usefulness of US to detect small adrenal tumors remains controversial (1)(2)(3)(4)(5). Recently, this problem has been offset with the improvement in resolution, thereby increasing the detection rate even for small adrenal tumors (3,4,6,7). Most aldosterone-producing adenomas (APA) are too small to be detected incidentally by imaging pro cedures (8,9).…”