Computed Tomography of the Adrenal Glands

Abstract

Conventional radiographic diagnostic examinations of the adrenal glands are often unsatisfactory. Plain abdominal radiography will detect adrenal calcification and large adrenal neoplasms but is an insensitive method of detecting adrenal abnormahties (McAlister and Lester, 1971). Excretory urography is useful only when the adrenal gland enlarges sufficiently to displace the kidney (Lang, 1966). The normal or only slightly enlarged adrenal gland is not usually detected by nephrotomography (Fagerberg, 1958; Pickering et al., 1975), and retroperitoneal pneumography is too invasive to be employed as a screening procedure. Adrenal angiography and venography are useful techniques to detect adrenal masses (Kahn, 1971; Reuter et al., 1967; Mitty et al., 1973), but the risks of arteriography, the technical difficulty, and potential risk of adrenal hemorrhage or infarction following adrenal venography (Bookstein etal., 1968; Gold etal., 1972) are significant limitations. Adrenal scintigraphy with ¹³¹I-labeled iodocholesterol (Troncone etal., 1977; Ryo etal., 1978; Conn etal., 1972) may localize adrenal adenomas, but a delay of 4–21 days following administration of the isotope is required before the examination is completed. A further limitation is poor spatial resolution due to radioactive dose considerations. Grey scale ultrasonography is capable of imaging some normal-sized and most abnormal adrenal glands with masses larger than 2 cm in diameter (Yeh etal., 1978; Sample and Sarti, 1978; Sample, 1976). The major limitation of ultrasonography is the high degree of technical expertise required to obtain and interpret the scans.