Abstract
Background and Study Aims: The value of transabdominal and endoscopic ultrasound (EUS) in detecting normal adrenal
glands is not yet established. The aim of our study was to evaluate whether these
techniques can be routinely used to visualize the adrenal glands in patients without
suspected adrenal pathology.
Patients and Methods: Transabdominal ultrasound was validated by examination of 10 corpses and was performed
in 80 healthy volunteers (3.5 and 5 MHz). EUS of the left adrenal gland was performed
in 154 consecutive patients referred for various other reasons. In 20 patients we
attempted to visualize the right adrenal gland as well.
Results: Both adrenal glands were correctly identified in all of the 10 corpses once they
were opened. In healthy volunteers, the right adrenal gland was visualized by transabdominal
ultrasound in 79/80 patients (99 %) and the left adrenal gland in 55/80 patients (69 %).
EUS allowed detection of the left adrenal gland in 151/154 patients (98 %). In three
patients EUS failed because of grossly distorted anatomy. In 6/20 patients we were
also able to detect the right adrenal gland by EUS, which was obvious in two cases
because of incidentalomas.
Conclusion: Visualization of the right adrenal gland is almost always possible by transabdominal
ultrasound, while its detection by EUS is successful only in some cases. The left
gland is more difficult to detect by transabdominal ultrasound, while it can nearly
always be seen using EUS. Therefore, a combined transabdominal and endoscopic ultrasonographic
approach is useful for visualization of the adrenal glands and may enable diagnosis
of even small adrenal masses.
