Use of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Adrenal Tumors in Dogs

2016 ◽  
Vol 52 (3) ◽  
pp. 132-143 ◽  
Author(s):  
Paolo Bargellini ◽  
Riccardo Orlandi ◽  
Alfredo Dentini ◽  
Chiara Paloni ◽  
Giuseppe Rubini ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Adrenal Mass ◽  
Adrenal Tumors ◽  
Adrenocortical Adenoma ◽  
Microbubble Contrast Agent ◽  
Contrast Enhanced ◽  
Different Types ◽  
Contrast Enhanced Ultrasonography ◽  
The Right ◽  
Mass Lesions

ABSTRACT We evaluated the diagnostic accuracy of the contrast-enhanced ultrasonography (CEUS), using a second-generation microbubble contrast agent, in differentiating the different types of adrenal mass lesions in 24 dogs. At B-mode ultrasound, 9 lesions involved the right adrenal gland, 14 the left, and 1 was bilateral. Each dog received a bolus of the contrast agent into the cephalic vein, immediately followed by a 5-mL saline flush. The first contrast enhancement of each adrenal lesion was evaluated qualitatively to assess the degree of enhancement and its distribution during the wash-in and wash-out phases, as well as the presence of non-vascularized areas and specific vascular patterns. Pathological diagnoses were determined in all dogs by histopathology or by cytology. Combining enhancement degree and vascularity resulted in the best predictive model, allowing CEUS to differentiate adrenocortical adenoma (n=10), adenocarcinoma (n=7), and pheochromocytoma (n=7) with an accuracy of 91.7% (P < 0.001). Combining enhancement degree and vascularity, CEUS can discriminate malignant versus benign adrenal lesions with a sensitivity of 100.0%, a specificity of 80.0%, and an accuracy of 91.7% (P < 0.001). In conclusion, results of this study confirm that CEUS is useful for differentiating between the different types of adrenal tumors in dogs.

scholarly journals SUN-154 Resistant Hypertension After Shockwave Lithotripsy: The Rude Awakening of an Adrenal Incidentaloma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ramon B Larrazabal
Keyword(s):  
Blood Pressure ◽  
Adrenal Mass ◽  
Adrenal Incidentaloma ◽  
Adrenal Tumors ◽  
Shockwave Lithotripsy ◽  
Adrenocortical Adenoma ◽  
Institutional Perspective ◽  
Surgical Interventions ◽  
First Case ◽  
Free Cortisol

Abstract BACKGROUND The National Institutes of Health defines adrenal incidentalomas (AIs) as clinically inapparent adrenal masses discovered inadvertently in diagnostic testing or treatment for conditions not related to the adrenal glands. Non-functional adenoma remains the most frequent (60–85%) cause, while functional adenomas at 5–16%. CLINICAL CASE A previously healthy 41 year-old female consulted for a 2-month history of left flank pain. Computed tomography (CT) scan of the kidneys revealed left calculi and incidental right adrenal mass. She was asymptomatic at this time. She then underwent shockwave lithotripsy for the renal calculi. However, post-operatively, she had elevated blood pressure and was started on anti-hypertensives. She remained hypertensive despite being on four different medications. Pertinent physical examination findings: plethora of the face and extremities, Moon facies, Buffalo Hump, and pendulous abdomen with grayish striae. Further work-up revealed the AI to be cortisol-secreting. Pertinent laboratories: 1 mg dexamethasone suppression test - 800 nmol/L (<50 nmol/L), 24-hr urine free cortisol - 1014.86 ug/24 hr (20–90 ug/24 hr), Adrenocorticotropic Hormone (ACTH) - 5.0 pg/ml (9–52 pg/ml). She then underwent a right laparoscopic adrenalectomy. Post-operatively, her blood pressure normalized without her anti-hypertensive medications. Tissue biopsy of the mass was consistent with an adrenocortical adenoma. On her follow-up after one month, signs of Cushing’s Syndrome were clinically improving. CONCLUSION This is the first case that demonstrated shockwave lithotripsy converting a non-functioning adrenal incidentaloma into a functioning one. It also shows how internists and surgeons (i.e. Urologists) can manage various aspects of patient care through the facilitation of medical treatments, surgical interventions, and ensuring a proper multidisciplinary approach based on the endocrinology clinical guidelines. So as not to delay the delivery of proper management to the patient. REFERENCES (1) Grumbach M, Biller B, Braunstein G. et al. “Management of the clinically inapparent adrenal mass (“incidentaloma”).” Annals of internal medicine 2003; 138:424–4292 Herrera M, Grant C, van Heerden J. et al. “Incidentally discovered adrenal tumors: an institutional perspective.” Surgery 1991; 110:1014.

Contrast-Enhanced EUS (CE-EUS) Using a New Microbubble Contrast Agent (MRX-815) - A Feasibility Study in a Porcine Model

2006 ◽  
Vol 63 (5) ◽  
pp. AB274
Author(s):  
Robert F. Wong ◽  
Orhan Tarcin ◽  
Nischita Reddy ◽  
Ijaz Ahmed ◽  
Douglas Brining ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Feasibility Study ◽  
Porcine Model ◽  
Microbubble Contrast Agent ◽  
Contrast Enhanced

scholarly journals Focal Liver Tumors: Characterization with 3D Perflubutane Microbubble Contrast Agent–enhanced US versus 3D Contrast-enhanced Multidetector CT

Radiology ◽  
2009 ◽  
Vol 251 (1) ◽  
pp. 287-295 ◽  
Author(s):  
Wen Luo ◽  
Kazushi Numata ◽  
Manabu Morimoto ◽  
Masaaki Kondo ◽  
Shigeo Takebayashi ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Liver Tumors ◽  
Multidetector Ct ◽  
Microbubble Contrast Agent ◽  
Contrast Enhanced

Diseases of the Adrenal Glands: Radiologic Diagnosis

PEDIATRICS ◽  
1964 ◽  
Vol 33 (2) ◽  
pp. 317-317
Author(s):  
FREDERIC N. SILVERMAN
Keyword(s):  
Adrenal Mass ◽  
Adrenal Glands ◽  
Adrenal Tumors ◽  
Radiologic Diagnosis ◽  
Clinical Syndromes ◽  
Mass Lesions ◽  
Retroperitoneal Air

The author presents a succinct view of diseases of the adrenal glands in which radiologic diagnosis, especially with presacral retroperitoneal air injections is an important consideration There are 15 brief chapters well illustrated and effectively documented (324 items are listed in the bibliography) of which 10 are devoted to individual adrenal mass lesions. The first 5 chapters include a classification of adrenal tumors and survey of clinical syndromes comments on conventional radiographic techniques and the technique of presacral retroperitoneal pneumography, and a consideration of adrenal calcifications and normal radiographic anatomy.

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