[CT diagnosis of adrenal gland diseases].
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Diseases of the adrenal glands are detectable by means of ultrasound under the condition of an enlargement of the organs. Due to the different advantages, sonography remains the first choice of imaging techniques, though computer tomography still ist superior and most useful for interdisciplinary discussion. Possibilities and limitations of the ultrasound evaluation of the adrenal glands are discussed.
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Adrenocortical disease is a frequent problem affecting pet ferrets in the United States. This article describes the typical history, signs, and diagnostic test results to be expected in ferrets with this disease. Treatment options are discussed. A newly developed diagnostic technique is also described.
In 60 normal control persons and 88 patients with diseases of the adrenal gland, sonographic examinations of the adrenals were carried out. Examination technique and typical sonographic findings in different adrenal lesions are presented. Normal-sized adrenal glands and space-occupying lesions measuring 8-12 mm in diameter could not be visualized in all instances. Adrenal sonography is quite suitable for a screening procedure, however, it is inferior to CT in spatial resolution and overall accuracy. In adrenal lesions exceeding 2 cm in diameter, the sensitivity of sonographic examinations equals that of computed tomography. Patients considered for surgical intervention always require exact delineation of adrenal diseases by computed tomography.
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Diseases and morphological changes of the adrenal gland play an important role especially in the newborn, because malformations, congenital errors of metabolism, connatal tumours and birth injuries become symptomatic in this period of life. In this paper, the possibilities of neonatal adrenal ultrasonography for diagnosis and in the aspect of differential diagnosis are discussed. The characteristic sonographic appearance is the thin echogenic core surrounded by a thick transonic zone. Adrenal haemorrhage as well as the neuroblastoma disturb these structures and show their own characteristic pattern. In congenital adrenal hyperplasia the organ is enlarged in a fold-like manner. In agenesis or displacement of the kidney the adrenal gland presents as an elongated mass in the renal fossa and on the psoas muscle.
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The authors present their own experience in diagnosing and surgical treatment of adrenal tumors. The group consisted of 52 patients with adrenal tumors treated surgically in our Department in 1980-1996. There were 37 women (71%) and 15 men (29%); 22 with Cushing syndrome, 14 with pheochromocytoma, 4 with Conn's syndrome, 1 with virilizing tumor, 1 with adenocarcinoma, 1 with adrenocortical carcinoma, 1 with ganglioneuroblastoma 2 with adenomas, 6 with adrenal cyst. Diagnosis pre- and intraoperative was verified with histological examination. We suggest that the ultrasonography and computed tomography are the most useful methods in determining of tumor localisation. The authors prefer intraperitoneal approach, enabling evaluation of the contralateral adrenal gland and possible localisation of extraadrenal foci. Good results were obtained in 51 patients (98%).