Standards of ultrasound imaging of the adrenal glands

Abstract

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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“…The statistical evaluation was performed with SPSS version 17.0 software (IBM Corporation, Armonk, NY), using the Student t test and χ test. P < .05 was considered statistically significant.…”

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“…Ultrasonography is a method of choice in the assessment of the adrenal glands in neonates and young children. 7 It is often the first line investigation in pediatrics, particularly for those presenting with an abdominal mass. 5 Approximately half of the patients present with the localized or regional disease and 35% have regional lymph node spread at the time of diagnosis.…”

US of Right Upper Quadrant Pain in the Emergency Department: Diagnosing beyond Gallbladder and Biliary Disease

“…Unless the adrenal hemorrhage results in a large hematoma, it is likely to be undetectable at abdominal US, particularly in adults, and will be identified more readily at CT (53,59). When an adrenal hematoma is visible at US, its appearance varies depending on the time course.…”