The adrenal glands are part of the human endocrine system. They are paired endocrine glands, and are responsible for the production of a number of hormones: adrenaline, norepinephrine, corticosteroids, mineralocorticoid. These substances - adrenal hormones - are responsible for the regulation of various processes in the human body, therefore, their excess and deficiency in a certain way affect health.
Adrenal glands regulate water and electrolyte exchanges, participate in the process of protein metabolism in the body. One has only to appear even a slight deviation in the work of the glands, as the body immediately reacts with atypical states and processes - metabolic disorders, disorders of reproductive function, jumps in body weight and general deterioration of health, the appearance of diseases. In order to identify such abnormalities and find the right therapy aimed at eliminating them, doctors prescribe various examinations, including computed tomography of the adrenal glands.
Computed tomography - how it works
The basis of the diagnostic method of computed tomography, or CT, is the principle of the difference in the degree of X-ray absorption by tissues of different densities. For its implementation used special devices - tomographs. The study by computed tomography is radiation, and allows the doctor to obtain a layer-by-layer image of the structure of the organ. The data recorded in the course of tomography, subjected to computer processing, thanks to which it is possible to visualize the organ on the monitor. The displayed image is the result of superimposing layer-by-layer images on each other with a cut-off step of 3 to 10 millimeters. So the doctor has the opportunity to see even the deep tissue of the body with the creation of its bulk model on the screen.
CT of the adrenal glands, most often, is part of a comprehensive examination of the abdominal cavity organs, but can also be administered 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 state of the blood and lymphatic vessels, a contrast method is used. For this purpose, a special contrast agent containing iodine is used. The drug is administered intravenously, after which a scan is performed several times in succession.
Indications for adrenal CT
Considering that a computer tomogram carries a certain radiation load for the organism, a doctor’s direction is required for it, and the presence of specific indications. Usually, an oncologist, therapist or endocrinologist will refer patients to the procedure.
The main purpose of such a diagnosis is the primary detection of pathologies and disorders, observation of them over time, or confirmation of a diagnosis. The doctor prescribes a CT scan of the adrenal glands:
- if you suspect any neoplasms;
- in case of lumbar injuries, to exclude hemorrhages and trauma of the adrenal glands;
- to study the size and location of organs, their vascular and lymphatic systems;
- if necessary, differentiate types of tumors;
- in the presence of symptoms of hormonal disorders, such as an increase in hair growth on the body, the appearance of disorders in the kidneys and weight gain, problems with libido;
- to observe the growth and change of tumors over time;
- to decide on the need for surgical intervention;
- to analyze the effectiveness of prescribed therapy;
- in the presence of persistent hypertension of malignant forms.
Use during the procedure of a contrast agent is negotiated with the patient in advance. In some cases, this decision is made already during CT, for example, if a tumor is detected in the process, the contrast allows for a more accurate visualization of the contours and internal structure of the formation, which is important for accurately determining the type of tumor.
Contraindications computed tomography
Despite the relative safety of this method of diagnosis, it has a number of contraindications. So, CT without contrasting is prohibited in such cases:
- in the presence of implants or prostheses made of metal, if they can not be removed at the time of the study;
- if the patient is less than three years old. For older children, computed tomography is also not recommended, except in exceptional cases;
- with diagnosed hypokinesis or convulsive syndrome, due to the fact that the patient needs to be in a completely immobilized state for some time;
- during pregnancy or breastfeeding: this restriction is valid for all types of research based on radiation exposure, as it can harm the fetus in the womb, or to an infant that has already appeared;
- with some mental disorders, with claustrophobia.
The method with the introduction of a contrast agent is also not recommended for patients:
- with severe allergies to iodine and iodine-containing drugs;
- with any form of hepatic or renal failure
- with severe diabetes.
If, in recent times, radiopaque studies using barium have been performed, CT scan of the adrenal glands with contrast should be temporarily postponed.
How to prepare for the study
The accuracy of the results directly depends on how carefully the patient reacts to the issue of preparation. All special requirements are indicated by the doctor in advance. If CT is planned without contrast, preliminary nutritional restrictions are not introduced, but it should be taken into account that the tomography is performed on an empty stomach. When CT scan with contrasting is planned, the subject needs to give up fatty and spicy food for a while; you can’t drink tea, coffee and strong drinks 4-5 days before. 5-6 hours before the study can not eat and drink at all. Also, at least a day before the procedure with contrast, you need to drink a solution of urografin.
Those who suffer from increased gas concentrations in the intestine are recommended to take activated carbon in advance. In the event of constipation shortly before the day of the CT, a cleansing enema is prescribed.
All metal devices, fixtures, decorations and removable dentures must be removed and left outside the office with a mobile phone, as they may distort the results.
The process of CT adrenal glands
First of all, the subject is placed on a special moving table of the tomograph, and asked to occupy a comfortable position. The doctor is in the next room during the procedure, but he sees and hears the patient and can also talk to him. A table with a man is pushed deep into the tomograph.
For the most accurate scan of the body, the person 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 belts.
The scanned image is displayed on the monitor, where it is examined and observed by the doctor. In the process of the survey, a series of images is taken, which will be carefully studied by physicians in the future. Also, information can be recorded on digital media.
In case the patient feels unwell or any changes in well-being, he should inform the doctor about it.
As for the method using contrast, the mechanism of its implementation is almost the same. A few hours before the scan, or directly during it, a contrast drug is injected intravenously. It does not disrupt the functioning of the organs, and is excreted by the kidneys after about a day.
The whole procedure, on average, takes no more than 30 minutes. After it is finished, the patient, at his request, is given printed CT images along with a digital medium in which they are stored. In some cases, after tomography, a person feels slightly dizzy, redness appears at the injection site of the contrasting drug, there may be a slight metallic taste in the mouth. After 3-4 hours all the sensations pass.
Computed tomography does not affect the ability of a person to drive a car or precise mechanisms.
What can computed tomography detect
According to the scan results, the doctor determines the size and location of the organs, the density of the tissues, their structure and integrity, as well as the compliance of all indicators with the norm. The pictures visualize signs of the presence of tumors and pathological inclusions:
- cysts and lipomas;
- cancer tumors;
- other types of tumors.
Especially effective adrenal CT scan is considered to detect cancer and the degree of metastasis. In this way, even the smallest neoplasms can be detected, which is especially important in case of cancer. The doctor is able to determine the nature of education, the dynamics of its development and growth, to work out the tactics of treatment.
Tomography also displays the size and location of hematomas in organs - they are distinguished by torn edges and tissue heterogeneity.
Advantages and disadvantages of the procedure, possible complications
Doctors, mostly positive comments on this method of diagnosis. It is non-invasive, so the risk of complications is minimal. The scanning process itself does not usually cause pain or discomfort to the patient. At any time, the subject may contact the doctor.
The most significant advantage of this procedure is the high accuracy of its results - provided that all the requirements of preparation and conduct are met, the images provide the most objective visualization of the organs. Adrenal glands are viewed from all sides, it is possible to build their volumetric model. The scale of the organs is transmitted as close as possible to the real ones.
However, there are some risks of tomography. First of all, they are associated with the radiation that the patient receives in the process. Of course, the level of radiation exposure from the 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. For emergency patient care, antihistamines are available in the CT room.
Be sure to notify the doctor about all the drugs taken by the test, as a contrast agent can react with them, not always safe for humans.
Alternative Adrenal Examination Methods
The easiest way, which can partially replace CT, is ultrasound. With it, you can see the anatomical characteristics of the body, its location, as well as the presence of inflammatory processes or pathologies in it. However, the accuracy of the adrenal ultrasound is significantly inferior to CT.
There is also another method for studying the state of internal organs - multispiral computed tomography. It is characterized by high accuracy of the data, but also uses radiation.
If the patient is forbidden to get x-ray exposure, the doctor prescribes an MRI. The mechanism of this study is based on the principles of the magnetic field, it is allowed to make children and pregnant women. Its disadvantage is considered to be 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 functioning of these glands. It is considered relatively harmless and highly accurate. The guarantee of obtaining the most realistic survey results is strict adherence to the requirements of preparing for it. In some cases, the CT of the adrenal glands is carried out using a contrast agent - this way the doctor is able to detect even the smallest deviations in the structure or functioning of the organs.