Computed tomography (CT) of the adrenal glands

The adrenal glands are part of the endocrine system of the human body. They are paired endocrine glands, and are responsible for the production of a number of hormones: adrenaline, norepinephrine, corticosteroids, mineralocorticoids. These substances – adrenal hormones – are responsible for the regulation of various processes in the human body, therefore, both their excess and deficiency in a certain way affect health.

The adrenal glands regulate water and electrolyte metabolism, participate in the process of protein metabolism in the body. As soon as even a slight deviation in the work of the glands appears, the body immediately reacts with conditions and processes that are atypical for it – metabolic disorders, reproductive disorders, jumps in body weight and a general deterioration in well-being, the appearance of diseases. In order to identify such abnormalities and choose the right therapy aimed at eliminating them, doctors prescribe various examinations, including computed tomography of the adrenal glands.

Computed tomography – how it works

The diagnostic method of computed tomography, or CT, is based on the principle of the difference in the degree of absorption of X-rays by tissues of different densities. For its implementation, special devices are used – tomographs. The study of computed tomography is a beam, and allows the doctor to get a layered image of the structure of the organ. The data recorded during tomography are subjected to computer processing, thanks to which it is possible to visualize the organ on the monitor. The displayed picture is the result of superimposing layer-by-layer images with a slice step from 3 to 10 millimeters. So the doctor has the opportunity to see even the deep tissues of the organ with the creation of its three-dimensional model on the screen.

CT scan of the adrenal glands, most often, is part of a comprehensive examination of the abdominal organs, but can also be prescribed as an independent examination. In some cases, when it is necessary to achieve maximum clarity of the contours, or when the doctor is going to study the condition of the blood and lymphatic vessels, the contrast method is used. For this purpose, a special contrast agent containing iodine is used. The drug is administered intravenously, after which scanning is performed several times in a row.

Indications for CT scan of the adrenal glands

Considering that a CT scan carries some radiation load for the body, it requires a doctor’s referral and specific indications. Typically, patients are referred to the procedure by an oncologist, internist or endocrinologist.

The main purpose of such diagnostics is the primary detection of pathologies and disorders, monitoring them in dynamics, or confirming the diagnosis. The doctor prescribes a CT scan of the adrenal glands:

• if you suspect the presence of any neoplasms;
• with injuries of the lumbar region, to exclude hemorrhages and trauma to the adrenal glands;
• to study the size and location of organs, their structure;
• if necessary, differentiation of types of neoplasms;
• in the presence of symptoms of hormonal disorders, such as increased growth of body hair, the appearance of impaired kidney function and jumps in body weight, problems with libido;
• to monitor the growth and change of neoplasms in dynamics;
• to resolve the issue of the need for surgical intervention;
• to analyze the effectiveness of the prescribed therapy;
• in the presence of stable hypertension of malignant forms.

The use of a contrast agent during the procedure is discussed with the patient in advance. In some cases, such a decision is made already during CT, for example, if a tumor is detected during the process, contrasting allows more detailed visualization of the contours and internal structure of the formation, which is important for accurately determining the type of tumor.

Contraindications for computed tomography

Despite the relative safety of this method of diagnosis, it has a number of contraindications. So, CT without contrast is prohibited in such cases:

• if the age of the patient does not reach three years. For older children, computed tomography is also not recommended, except in exceptional cases;
• during pregnancy: this limitation is true for all types of studies based on radiation exposure, as it can harm the fetus in the womb, or the baby that has already been born;
• with some mental disorders, with claustrophobia.

The method with the introduction of a contrast agent is also not recommended for patients:

• with severe allergy to iodine and iodine-containing drugs;
• with any form of hepatic or renal insufficiency
• with severe forms of diabetes.

If radiopaque studies using barium have recently been performed, CT of the adrenal glands with contrast should be postponed for a while.

How to prepare for the study

The accuracy of the results obtained directly depends on how carefully the patient treats the issue of preparation. The doctor informs about all special requirements in advance. If a CT scan without contrast is planned, no preliminary dietary restrictions are introduced, however, it should be taken into account that the tomography is performed on an empty stomach. When a CT scan with contrast is scheduled, you should not eat or drink 3-4 hours before the start of the study.

Those who suffer from increased gas formation in the intestines are recommended to take activated charcoal beforehand, as well as to follow a diet that excludes foods that cause flatulence 5-6 days before the procedure. If constipation occurs shortly before the day of the CT scan, a cleansing enema is prescribed.

All metal devices, devices, jewelry and removable dentures must be removed and left outside the office along with a mobile phone, as they can distort the results.

The process of performing a CT scan of the adrenal glands

First of all, the subject is placed on a special moving table of the tomograph, and asked to take a comfortable position. The doctor during the procedure is in the next room, but he sees and hears the patient, and can also talk to him. The table with the person is pushed deep into the tomograph.

For the most accurate body scan, the person being examined must take a completely immovable position, and from time to time he will need to hold his breath as directed by the doctor. In some cases, it is even fixed with straps.

The scanned image is displayed on the monitor, where it is studied and observed by the doctor. During the examination, a series of images are taken, which will later be carefully studied by the radiologist. Information can also be recorded on digital media.

If the patient feels unwell or any change in well-being, he must inform the doctor about it.

As for the method with the use of contrast, the mechanism of its implementation is almost the same. But after the first (native) scan, the table with the patient is rolled out, he is given a dropper with a contrast agent, which is then injected during the second scan, while the flow of contrast is recorded from the first seconds. The contrast does not interfere with the functioning of the organs, and is excreted by the kidneys in about a day.

The whole procedure, on average, takes no more than 30-40 minutes. After its completion, the patient, at his request, is given printed CT images along with the digital media on which they are stored. In some cases, after a tomography, a person feels a slight dizziness, redness appears at the injection site of the contrast agent, and there may be a slight metallic taste in the mouth. After 3-4 hours, all sensations pass.

Computed tomography does not affect the ability of a person to drive a car or precise mechanisms.

What can a CT scan detect?

Based on the results of the scan, the doctor determines the size and location of organs, tissue density, their structure and integrity, as well as the compliance of all indicators with the norm. The images visualize signs of the presence of neoplasms and pathological inclusions:

• adenoma;
• cysts and lipomas;
• cancerous tumors;
• other types of neoplasms.

CT of the adrenal glands is considered especially effective for detecting a cancerous tumor and the degree of development of metastases. In this way, even the smallest neoplasms can be detected, which is especially important in oncological diseases. The doctor is able to determine the nature of education, the dynamics of its development and growth, to develop treatment tactics.

Tomography also displays the size and location of hematomas in the organs – they are distinguished by torn edges and tissue heterogeneity.

Advantages and disadvantages of the procedure, possible complications

Doctors generally respond positively to this method of diagnosis. It is non-invasive, so the risk of complications is minimal. The scanning process itself usually does not cause pain or discomfort to the patient. At any time, the subject can contact the doctor.

The most significant advantage of this procedure is the high accuracy of its results – subject to all the requirements of preparation and conduct, the images provide the most objective visualization of organs. The adrenal glands are viewed from all sides, it is possible to build their three-dimensional model. The scales of the organs are transmitted as close as possible to the real ones.

However, there are some risks associated with imaging. First of all, they are associated with the radiation that the patient receives in the process. Of course, the level of radiation exposure from a tomograph is very small, but if the procedure is carried out too often, it can become a catalyst for the growth of cancerous tumors.

Another danger is the likelihood of allergic reactions to iodine. Antihistamines are on hand in the CT room for emergency patient care.

Be sure to notify the doctor about all the drugs taken by the subject, since the contrast agent can react with them, which are not always safe for humans.

Alternative methods of examination of the adrenal glands

The simplest method, which can partially replace the CT scan, is ultrasound. With it, you can see the anatomical characteristics of the organ, its location, as well as the presence of inflammatory processes or pathologies in it. However, the accuracy of the results of ultrasound of the adrenal glands is significantly inferior to CT.

There is another method for studying the state of internal organs – multislice computed tomography. It is distinguished by the high accuracy of the data obtained, however, it also uses radiation exposure.

If the patient is not allowed to be exposed to x-rays, the doctor will order an MRI. The mechanism of this study is based on the principles of the magnetic field, it is allowed to do it to children and pregnant women. Its disadvantage is the higher cost compared to computed tomography.

The modern method of studying the state of the adrenal glands – computed tomography – is prescribed by a doctor if it is established that a person has malfunctions and disturbances in the work of these glands. It is considered relatively harmless and highly accurate. The guarantee of obtaining the most realistic results of the examination is the strict observance of the requirements for preparation for it, which is why in some cases a CT scan of the adrenal glands is performed using a contrast agent – this way the doctor is able to identify even the most minor deviations in the structure or functioning of organs.