X-ray of the adrenal glands

Radiation methods are of considerable help to the clinician in the recognition of adrenal lesions. On the survey radiographs, these glands are not visible. Only in cases where Addison's disease is associated with tuberculosis of the adrenal glands, in the latter, small deposits of lime are sometimes noticeable. In this regard, the simplest method of radiation research is sonography. We only note that normal or slightly enlarged adrenal glands on sonograms do not always appear loosely.

On computer tomograms, the adrenal gland can be detected as an entity located above the upper pole of the kidney and somewhat anterior to it. A normal gland causes a small oval or triangular formation with straight or convex contours. The tumor leads to its increase and deformation. Computerized tomograms allow detecting tumors with a diameter of only 0.5-1.0 cm. Even more sensitive is MRI, especially when adrenal cortex is hyperplasia (in sonography and CT, only half of patients have hyperplasia). Scintigraphy of the adrenal glands was also developed. It is carried out by intravenous administration of 99mTc-MIBG. The normal adrenal gland forms the center of accumulation of RFP above the upper pole of the kidney. This technique is rarely used due to the much greater diagnostic capabilities of CT and MRI. However, it is useful in differentiating hyperplasia and adrenal gland tumors. With adenoma, one adrenal gland is enlarged, in which a large number of RFPs accumulate, whereas the function of the second is suppressed. With nodular hyperplasia, one adrenal gland is also enlarged and well concentrated, and the second has small dimensions and weakly accumulates RFP.

The adrenal gland disorder manifests itself in various clinical syndromes and is characterized by specific laboratory data (Itenko-Cushing syndrome, Conn's syndrome - primary aldosteronism, symptomatic hypertension due to the development of pheochromocytoma). The organic basis of the Itenko-Cushing syndrome is most often bilateral hyperplasia of the adrenal cortex (mainly due to the appearance of the pituitary adenoma), and Conn's syndrome is hyperplasia or a tumor (usually benign adrenal adrenal adrenal gland). Accordingly, the tactics of radiological examination are being constructed, in which the leading place is occupied by CT.

From the above, it is clear that with the Itenko-Cushing syndrome, the study should be supplemented with radiography, CT or MRI of the Turkish saddle region in search of the pituitary adenoma. In addition, with this syndrome, a radiograph of the skeleton is performed. At a young age there is a slowdown in the growth of bones Owing to the violation of mineral metabolism, systemic osteoporosis occurs. Fractures of the ribs and vertebral bodies are often present, as well as aseptic necrosis of bones.

Investigation of venous blood for the content of adrenal hormones is performed by the method of adrenal vein catheterization by transfemoral access with subsequent contrast venography and collection of blood samples from these veins and inferior vena cava. The procedure is invasive and technically complex, producing it in an angiographic room. Testing of venous blood is a fairly reliable test for distinguishing between one- and two-sided hyperplasia and adenoma, as well as intra- and extraadrenal location of pheochromocytoma.

In the adrenal glands, metastases of cancer are often detected. A sad superiority here belongs to breast and lung cancer, which should be taken into account in clinical and radiological examination of patients.