[Physiopathology and clinical aspects of the relations between the adrenal glands and the cardiovascular system].
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Ultrasonography has become an important modality for imaging adrenal glands in small animals. Normal adrenal glands and structural abnormalities, such as changes in size, shape, and echogenicity, can be identified. In the case of adrenal tumors, ultrasonography is a valuable tool for identifying neoplastic masses with local and regional involvement, as well as potential abdominal metastases. When correlated with clinical findings and results of hematologic, serum biochemical and endocrine tests, ultrasonographic findings make a substantial contribution to the diagnosis of adrenal diseases in dogs, cats, and ferrets.
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Hydatide disease of the adrenal gland is extremely rare, even in disseminated disease. Isolated cyst of the gland is even more rare. Only 9 of such cases seem to have been described so far. We present a 49 year old woman in whom a hydatide cyst of the right gland was found during the investigation for the dull pain in the area. She was successfully operated. Hydatide etiology was confirmed at operation and by histology. She had an uneventful recovery. The preoperative pain disappeared postoperatively.
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A prospective study of the accuracy of computed tomography (CT) and ultrasound was undertaken in 112 consecutive patients with suspected adrenal disease. CT had a sensitivity of 84% (47/56), a specificity of 98% (55/56), and an accuracy of 90%. Ultrasound had a sensitivity of 79% (22/28), a specificity of 61% (14/23), and an overall accuracy of 70%. When patients with Cushing disease and adrenal hyperplasia were excluded, and only masses such as pheochromocytoma, adenoma, and carcinoma were considered, the sensitivity of both CT and ultrasound was increased. Receiver operating characteristic (ROC) curves differed for CT and ultrasound, and strongly supported the diagnostic superiority of CT.
We report a case of chronic expanding hematoma in the adrenal gland. Mixed signal intensity in a mosaic pattern was seen on T2-weighted images. A focal area suggesting a subacute hematoma was also noted. The dynamic CT scan showed heterogeneous contrast enhancement in the arterial phase and heterogeneous spread of the enhanced area within the tumor. Awareness of this finding may prevent the misdiagnosis of a tumor as a neoplastic intratumoral hemorrhage.
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