Sonografie und Endosonografie der Nebennieren

Jenssen, Christian; Dietrich, C. F.

doi:10.1055/s-0029-1245449

Cited by 26 publications

(22 citation statements)

References 39 publications

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“…In a neonate, there can be a hyperechoic center corresponding to the medullar layer and a hypoechoic edge that corresponds to the cortical layer. The ultrasound corticomedullar differentiation blurs with age (3, 8) .…”

Section: Anatomy Of the Adrenal Region And Scanning Techniquementioning

confidence: 99%

“…By contrast with schematic figures presented in various anatomical atlases, the adrenal gland is a narrow organ with the limb diameter of 4–9 mm (5 ± 1 mm) and the body diameter of up to 10 mm. Its length reaches up to 50 mm (8) . In an ultrasound examination, this organ is usually hypoechoic or its echogenicity resembles that of the perirenal fat tissue, which might make its visualization more difficult (Fig.…”

Section: Anatomy Of the Adrenal Region And Scanning Techniquementioning

confidence: 99%

“…However, the literature mentions that focal lesions with the diameter of 5 mm can be visualized via the abdominal access and those with 2–3 mm in diameter can be detected in endoscopic ultrasound (8) . Nevertheless, some tumors with their maximum diameter below 20 mm in the left adrenal gland can remain invisible for transabdominal ultrasonography.…”

Section: Anatomy Of the Adrenal Region And Scanning Techniquementioning

confidence: 99%

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Standards of ultrasound imaging of the adrenal glands

et al. 2015

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Adrenal glands are paired endocrine glands located over the upper renal poles. Adrenal pathologies have various clinical presentations. They can coexist with the hyperfunction of individual cortical zones or the medulla, insufficiency of the adrenal cortex or retained normal hormonal function. The most common adrenal masses are tumors incidentally detected in imaging examinations (ultrasound, tomography, magnetic resonance imaging), referred to as incidentalomas. They include a range of histopathological entities but cortical adenomas without hormonal hyperfunction are the most common. Each abdominal ultrasound scan of a child or adult should include the assessment of the suprarenal areas. If a previously non-reported, incidental solid focal lesion exceeding 1 cm (incidentaloma) is detected in the suprarenal area, computed tomography or magnetic resonance imaging should be conducted to confirm its presence and for differentiation and the tumor functional status should be determined. Ultrasound imaging is also used to monitor adrenal incidentaloma that is not eligible for a surgery. The paper presents recommendations concerning the performance and assessment of ultrasound examinations of the adrenal glands and their pathological lesions. The article includes new ultrasound techniques, such as tissue harmonic imaging, spatial compound imaging, three-dimensional ultrasound, elastography, contrast-enhanced ultrasound and parametric imaging. The guidelines presented above are consistent with the recommendations of the Polish Ultrasound Society.

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Section: Anatomy Of the Adrenal Region And Scanning Techniquementioning

confidence: 99%

Section: Anatomy Of the Adrenal Region And Scanning Techniquementioning

confidence: 99%

Section: Anatomy Of the Adrenal Region And Scanning Techniquementioning

confidence: 99%

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Standards of ultrasound imaging of the adrenal glands

et al. 2015

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“…[8586] Studies regarding EUS-FNA have been published,[87] citing a very good accuracy, although the number of masses was very low. On the other hand, EUS elastography of the adrenal glands has only been described in reviews and case reports, not in prospective or retrospective studies.…”

Section: Clinical Applications Of Fna and The Role Of Eus-elastographmentioning

confidence: 99%

Can elastography replace fine needle aspiration?

Popescu

Săftoiu

2014

Endosc Ultrasound

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Endoscopic ultrasound (EUS) is one of the best diagnostic methods for diseases of the digestive tract and surrounding organs. Whereas EUS-guided fine needle aspiration (FNA) has been very useful for providing histological confirmation for previously hard to reach lesions, elastography is aiming to obtain a “virtual biopsy” by assessing differences in elasticity between the normal and pathological – usually malignant – tissue. A question that arises is whether EUS-elastography has reached a stage where it might successfully supplant the use of EUS-FNA in some of its clinical indications. The main indications of EUS-guided FNA are listed in this article and published data on the usage of elastography in these settings is reviewed for each one. In some of the indications, a plethora of studies have been published, notably for the evaluation of solid pancreatic masses and lymph nodes, while in others there is little relevant data (submucosal masses, left liver lesions, left adrenal masses), or elastography simply is not suitable as a diagnostic means (cystic lesions). Our conclusion is that elastography is not yet ready to replace EUS-FNA in its indications, but should complement it in various settings, especially for the assessment of lymph nodes. It can only be considered an alternative on a case-by-case basis, in situations where FNA is regarded as a contraindication. Furthermore, it could be used in conjunction with other imaging techniques, such as contrast-enhanced EUS, in order to further improve the accuracy of non-invasive EUS assessment, possibly making the case for a more limited or targeted use of EUS-FNA in selected cases.

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“…Müssen rezente Leitlinien zur Abklärung von NNRF umgeschrieben werden [3,4]? Werden wir noch öfter als bisher auf die Biopsie der NNRF verzichten können [5,6]? Die bisherigen Ergebnisse zur Frage der Differenzierung benigner oder maligner NNRF mit CEUS und US-Kontrastmittel der zweiten Generation sind nicht ermutigend: Mit visueller Beurteilung der Kontrastmittelaufnahme bei 58…”

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CEUS von Nebennierenraumforderungen – der Durchbruch?

Mostbeck¹

2011

Ultraschall in Med

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In diesem Heft berichten M. Friedrich-Rust et al. [1] ihre Erfahrung mit der Kontrastmittel-Sonografie (CEUS) zur Differenzierung benigner und maligner Nebennierenraumforderungen. Diese Arbeit ist eine Erweiterung und Fortführung einer im Jahr 2008 im AJR publizierten Studie [2], 34 von 35 dieser Studienpatienten sind auch in das Studienkollektiv der rezenten Arbeit (108 Patienten mit 116 Nebennierenraumforderungen [NNRF]) inkludiert [1]. Die Ergebnisse klingen ermutigend: Unter Verwendung einer gerätespezifischen Software wurden Zeit-Intensitäts-Kurven der Kontrastmittelanflutung (4,8 ml SonoVue ® , Bracco International, Mailand, Italien) in den Nebennierenraumforderungenund im Vergleich dazu als Referenz auch in Leber bzw. Milzausgewertet und nach 4 Mustern klassifiziert, wobei das entscheidende Kriterium die Kontrastmittelanflutungszeit (CE) von der Applikation i. v. bis zum Erkennen des Kontrastmittels in der region of interest (ROI) ist (Muster Ifrüharterielle CE; Muster IIarterielle CE, Muster IIIspäte CE, Muster IVkeine CE) [1]. Daneben wurden die Real-Time-Sonomorphologie und die Vaskularisation im Farbdoppler dieser NNRF beurteilt [1]. Die Ergebnissekurz zusammengefasstklingen optimistisch: Wertet man die Muster I und II (also eine sehr früh erkennbare, "arterielle" Kontrastmittelaufnahme) als "maligne" Muster und Muster III und IV als "benigne", dann zeigt sich in diesem Kollektiv eine Sensitivität von 100 %, eine Spezifität von 67 %, ein neg. Vorhersagewert von 100% und ein pos. Vorhersagewert von 33 % für eine maligne NNRF [1]. Nach Ausschluss von 5 (Angio-)Myelolipomen (die nach Meinung der Autoren eine charakteristische Real-Time-Sonomorphologie haben) und nach Ausschluss aller 12 Phäochromozytome (die nach Meinung der Autoren ja klinisch-laborchemisch diagnostiziert werden) steigt die Sensitivität auf 79% an [1]. Haben wir damit den Durchbruch erreicht, um zwischen benignen, häufig "inzidentell" gefunden NNRF und malignen, primären oder sekundären NNRF einfach und kostengünstig ohne Computertomografie (CT) und Magnetresonanztomografie (MR) mit US alleine zu differenzieren? Müssen rezente Leitlinien zur Abklärung von NNRF umgeschrieben werden [3, 4]? Werden wir noch öfter als bisher auf die Biopsie der NNRF verzichten können [5, 6]? Die bisherigen Ergebnisse zur Frage der Differenzierung benigner oder maligner NNRF mit CEUS und US-Kontrastmittel der zweiten Generation sind nicht ermutigend: Mit visueller Beurteilung der Kontrastmittelaufnahme bei 58 In this issue M. Friedrich-Rust et al. [1]report on their experience using contrast-enhanced ultrasound (CEUS) for differentiating between benign and malignant adrenal mass lesions. The paper expands upon a study published in 2008 in the AJR, and 34 of 35 of those study patients are also included in the recent study collective (108 patients with 116 adrenal mass lesions) [1]. The results are encouraging: Using unit-specific software, time-intensity curves of the contrast enhancement (4.8 ml SonoVue ® , Bracco International, Milan, Italy) in the adrenal m...

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Sonografie und Endosonografie der Nebennieren

Cited by 26 publications

References 39 publications

Standards of ultrasound imaging of the adrenal glands

Standards of ultrasound imaging of the adrenal glands

Can elastography replace fine needle aspiration?

CEUS von Nebennierenraumforderungen – der Durchbruch?

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