ENDOSONOGRAPHY OF THE ADRENAL-GLANDS - NORMAL SIZE - PATHOLOGICAL FINDINGS

Transabdominal sonography of the adrenal glands frequently is non-succ essful. It was the aim of this project to improve the imaging of the a drenal glands using high resolution sonography in order to obtain info rmation about even small changes in these organs. Therefore, endosonog raphic imaging was investigated using an endosonoscope PENTAX FG32UA. The correct identification of the adrenal glands was examined in five human cadavers. A total of 58 patients with 113 adrenal glands (in 3 c ases history of unilateral adrenalectomy) were investigated. 109 adren al glands (97%) were identified and evaluated. Healthy adrenal glands are slightly hyperechoich and regarding their echogeneity comparable t o other endocrine organs such as the testes or the thyroid. Adrenal si ze can be determined as largest cross sectional area and was found to be 216 +/- 93 mm(2) right and 231 +/- 98 mm(2) left. In the adrenal gl ands which could be imaged by endosonography, all findings detected by CT (n = 33) or MRI (n = 19) could also be demonstrated endosonographi cally. Additional information as compared to CT/MRI was obtained in 7 out of 33 and in 6 out of 19 patients. This concerns in particular dif ferentiation between tumor and hyperplasia and detection of small adre nal adenomas. High resolution endosonography of the adrenal glands can provide information about adrenal gland morphology which cannot be ob tained by any other diagnostic approach.