Comparative value of radiological tests establishing lesions in adrenal glands

Aims: To examine diagnostical possibilities of lesions in adrenal glands and to compare the results with the results of histological material taken during surgery. Objectives: 1) To work out the value of ultrasound examination when assessing the condition of the adrenal glands. 2) To assess the value of computer tomography examination in the investigation of adrenal glands alterations. 3) To establish the influence of intravenous contrast agents differentiating possible benign or malignant alterations in adrenal glands 4) To estimate the congruence of adrenal gland alterations assessed by radiological tests and postoperative tests results. Methods: Profiles of radiological tests and medical documentation of the patients, who had their lesions of adrenal gland surgically removed in 2015, have been retrospectively reviewed. All 19 patients have been examined using ultrasound in the dispensary. However, alterations have been found only in 11 of them. Extra radiological tests have been made and evaluated during hospitalization. Tumor size, possible type and origin have been evaluated. The results got have been compared with the results of other radiological tests as well as with the results of histological material taken during surgery. Measurements have been made using Microsoft Excel 2013 program. Results: The profiles of 12 women (63%) and 7 men (37%), whose avarage age is 55,6 ± 2,3 years, have been examined. All patients have been examined by ultrasound and alterations have been found in 11 of them. In oder to specify diagnosis extra tests: 9 CT with and 7 without using contrast agents as well as 2 MRI have been made. The extra made tests detected 8 ACC (42%), 4 pheochromocytomas (21,1%), 3 metastasis (15,7%), 1 sarcoma (5,25%), 1 angiolipoma (5,25%), 2 unidentified lesions (10,5%). The avarage size of ACC is 3,25cm. Size frequency distribution: smaller than 2 cm (50%), ranging from 2 to 4 cm (25%), bigger that 4 cm (25%). The average size of not-ACC lesions is 6,4 cm. Size frequency distribution: 4 cm (50%). By origin 16 (84,2%) are primary adrenal tumors, 2 (10,5%) metastasis of tumor, 1 (5,3%) unclassified as tumor. 63,2% have coincided while comparing extra radiological tests results with the results of hystological material taken during surgery, and 7 (36,8%) of them have not. Conclusion: Ultrasound cannot always assess the condition of adrenal glands, but it is appropriate as a selective test. CT without a contrast agent is quite sensitive while looking for alterations in adrenal glands < 1 cm, however, it‘s specificity is partial. CT with contrast agent in different contrast fases can identify signs of benign or malignant alterations and is one of the most informative radiological tests used and evaluated. Comparing radiological diagnostic methods with histological tests of postoperative material, the most accurate and specific test is CT with a contrast agent