ENDOSONOGRAPHIC IMAGING OF THE ADRENAL-GL ANDS - A NEW METHOD

In contrast to the reliable imaging of the adrenal gland in infants an d children, transabdominal sonography of the adrenal glands is often u nsuccessful. Aim: To improve the imaging of the adrenal glands with hi gh resolution in order to obtain information on even small changes in these organs. Method: Adrenal glands taken from human cadavers were in vestigated using a 7.5 MHz transducer. Thereafter, endosonographic ima ging was investigated in 5 human cadavers using an endosonoscope PENTA X FG32 UA (longitudinal sector scanning, 7.5 MHz). Furthermore, the ad renal glands were imaged in a total of 30 patients with different indi cations for endosonography. Results: The adrenal glands in 5 human cad avers could be identified in each case. This was proved in one human c adaver by endosonographically guided fine needle puncture with consecu tive preparation of the tissue damage caused by the needle. In a total of 30 patients with 56 adrenal glands (in 4 cases preview history of unilateral adrenalectomy), 55 adrenal glands were correctly identified and evaluated. The only exception was the left adrenal gland of a pat ient with Billroth-II-stomach, which was slightly pulled to the right and very small. Healthy adrenal glands are slightly hyperechoic as com pared to the parenchyma of the kidney and have echogeneity comparable to other endocrinal organs such as the testicles or the thyroid. Endos onographic imaging of the adrenal glands is far superior in resolution and determination to transabdominal sonography. In 18 of 30 patients (60%) endosonography provided additional diagnostic information compar ed to conventional sonography. Conclusion: Endosonography of the adren al glands enables imaging of these organs with high resolution using a 7.5 MHz transducer from a distance of 1-2 cm.