DETECTION OF THE ADRENAL-GLANDS BY ENDOSCOPIC OR TRANSABDOMINAL ULTRASOUND

Background and Study Aims: The value of transabdominal and endoscopic ultrasound (EUS) in detecting normal adrenal glands is not yet establi shed. The aim of our study was to evaluate whether these techniques ca n be routinely used to visualize the adrenal glands in patients withou t suspected adrenal pathology. Patients and Methods: Transabdominal ul trasound was validated by examination of 10 corpses and was performed in 80 healthy volunteers (3.5 and 5 MHz). EUS of the left adrenal glan d was performed in 154 consecutive patients referred for various other reasons. In 20 patients we attempted to visualize the right adrenal g land as well. Results: Both adrenal glands were correctly identified i n all of the 10 corpses once they were opened. In healthy volunteers, the right adrenal gland was visualized by transabdominal ultrasound in 79/80 patients (99%) and the left adrenal gland in 55/80 patients (69 %). EUS allowed detection of the left adrenal gland in 151/154 patient s (98%). In three patients EUS failed because of grossly distorted ana tomy. In 6/20 patients we were also able to detect the right adrenal g land by EUS, which was obvious in two cases because of incidentalomas. Conclusion: Visualization of the right adrenal gland is almost always possible by transabdominal ultrasound, while its detection by EUS is s uccessful only in some cases. The left gland is more difficult to dete ct by transabdominal ultrasound, while it can nearly always be seen us ing EUS. Therefore, a combined transabdominal and endoscopic ultrasono graphic approach is useful for visualization of the adrenal glands and may enable diagnosis of even small adrenal masses.