Adrenal gland ultrasound is a diagnostic method that visualizes paired adrenal glands: their size, location, tissue structure, contour features, the presence of tumor and other formations. The study is informative in the diagnosis of cancer, aldosteromas, adenomas, cysts, hyperplasia. The procedure is carried out through lateral and anterior accesses. The main ultrasound mode is two-dimensional echography. In combination with ultrasound of the adrenal glands, Dopplerography is often performed.
There are no strict requirements regarding preparation for ultrasound of the adrenal glands. To increase the probability of obtaining a high-quality image, it is recommended to adhere to a number of rules that reduce the process of gas formation in the digestive tract:
- Diet. 2-3 days before the examination, it is necessary to exclude gas-forming products from the diet: legumes, cabbage, fresh bread, confectionery, carbonated drinks, fatty and fried dishes.
- The period of hunger. The procedure should preferably be performed on an empty stomach, 8-12 hours should pass after eating. Newborns and infants can be fed 3-3.5 hours before the study.
- Taking laxatives. Doctors prescribe laxatives to individual patients, which should be taken on the eve of sonography.
Ultrasound of the adrenal glands in B-mode gives a two-dimensional image that allows you to determine the location of paired organs, their size, the clarity of contours, the uniformity of the internal structure and the presence of foreign inclusions. During Dopplerography, the features of the organ’s blood supply are investigated: the patency of veins and arteries, the speed and direction of blood flow, the tortuosity of blood vessels. The maximum size of a healthy adrenal gland in the projection does not exceed 2-2.5 cm, on the monitor of the ultrasound apparatus, the gland is represented as a thin echogenic strip. With pathological enlargement of the organ, visualization becomes clearer. Ultrasound reveals the following diseases:
- Adrenal hyperplasia. The main sign of adrenal hyperplasia is an increase in the size of one or two organs. With a diffuse variant of the disease, the entire adrenal gland increases, with a focal one – separate areas having an irregular shape and clear contours.
- Adrenal cancer. Malignant tumors of the adrenal glands are visualized as areas of altered echogenicity (more often elevated) with uneven edges. The structure of the affected organ becomes heterogeneous
- Cyst. The presence of an adrenal cyst is indicated by an anechoic rounded area with clear contours, a dense hyperechoic capsule, distal amplification.
- Benign tumors. Benign neoplasms of the adrenal glands include aldosteromas and adenomas. They are displayed as homogeneous areas with low echogenicity and a clear contour.
- Pheochromocytoma. Both benign and malignant pheochromocytoma are possible. Neoplasia often has large dimensions, is a hyperechoic area of irregular shape with small anechoic areas.
Regardless of the nature of the pathology of the adrenal glands, ultrasound results are not enough to make a diagnosis. The technique shows structural changes in the endocrine organs. The data obtained are interpreted taking into account the clinical picture and indicators of laboratory studies of hormones, sometimes indicate the need for additional CT, MRI of the adrenal glands.
Ultrasound of the adrenal glands is safe, does not lead to the development of side effects, therefore it is prescribed to children, pregnant, nursing mothers and the elderly. Compared with other methods of organ imaging – MRI, CT, X–ray studies – ultrasound has a lower cost, which allows it to be widely used in the primary diagnosis of diseases. A significant disadvantage of the method is the difficulty of visualizing the adrenal glands associated with their size and location features – layers of subcutaneous and retroperitoneal adipose tissue, muscles and intestines prevent the passage of ultrasound waves, reducing the quality of the ultrasound image.