In contrast to the reliable imaging of the adrenal gland in infants and children, transabdominal sonography of the adrenal glands is often unsuccessful.
Aim: To improve the imaging of the adrenal glands with high resolution in order to obtain information on even small changes in these organs.
Method: Adrenal glands taken from human cadavers were investigated using a 7.5 MHz transducer. Thereafter, endosonographic imaging was investigated in 5 human cadavers using an endosonoscope PENTAX FG32 UA (longitudinal sector scanning. 7.5 MHz). Furthermore, the adrenal glands were imaged in a total of 30 patients with different indications for endosonography.
Results: The adrenal glands in 5 human cadavers could be identified in each case. This was proved in one human cadaver by endosonographically guided fine needle puncture with consecutive 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 patient with Billroth-II-stomach, which was slightly pulled to the right and very small. Healthy adrenal glands are slightly hyperechoic as compared to the parenchyma of the kidney and have echogeneity comparable to other endocrinal organs such as the testicles or the thyroid. Endosonographic 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 compared to conventional sonography.
Conclusion: Endosonography of the adrenal glands enables imaging of these organs with high resolution using a 7.5 MHz transducer from a distance of 1-2 cm.