Ultraschall Med 2008; 29 - OP_3_3
DOI: 10.1055/s-2008-1079829

Contrast enhanced ultrasound for imaging of adrenal masses

A Ignee 1, B Braden 2, AP Barreiros 1, D Schreiber-Dietrich 1, G Schuessler 1, CF Dietrich 1
  • 12nd Medical Department, Caritas Hospital Bad Mergentheim, Germany
  • 2Department of Gastroenterology, John Radcliffe Hospital, Oxford, UK

Aim: The number of incidentally discovered adrenal masses is growing due to the increased use of modern high resolution imaging techniques. However, the characterization and differentiation between benign and malignant adrenal lesions is challenging. This study aimed to evaluate contrast-enhanced ultrasound (CEUS) for characterization of adrenal masses.

Materials and methods: 58 patients with adrenal masses detected on CT/MR or ultrasound were included. 7 patients had bilateral adrenal lesions. All ultrasound examinations were performed using high-resolution ultrasound (3.5–7MHz). The contrast enhancement pattern of all adrenal lesions was documented after intravenous injection of 2.4ml SonoVue®.

Results: The 18 malignant adrenal tumours were significantly larger at time of diagnosis compared to the 40 benign lesions (p<0.03). The majority of benign adrenal lesions (37/40) had an unspecific type of contrast enhancement (24/40) or a peripheral to central contrast filling (13/40) as described as iris phenomenon. Similar findings were observed in malignant adrenal tumours. Most malignant lesions also showed unspecific (6/18) or peripheral to central contrast filling (9/18).

Conclusions: CEUS facilitates the visualisation of the vascularisation even in small adrenal masses, but it does not help to distinguish malignant and benign lesions.