P09.11: The value of new 2D and 3D US techniques in fetal adrenal gland assessment

Abstract

The aim of the study was to assess fetal normal and pathological adrenal glands with the use of new 2D and 3D US techniques. Adrenal glands of 243 healthy fetuses and 7 fetuses with the postnatal diagnosis a hemorrhage and hypoplasia were investigated in terms of 20–40 weeks with the help of US. In 2D US imaging enhancement (Dynamic Magnetic Resonance imaging) and in 3D US Extended Imaging technology—Multi-Slice View and volume calculation (VOCAL) were used (Accuvix XQ, Medison, Korea). The size, volume and a parenchyma structure of adrenal glands were assessed. During normal development the size and volume of fetus adrenal glands enlarged correspondingly to gestation age and kidneys size. Size and volume difference between right and left adrenal gland was not found. The analysis of adrenal gland echo structure has allowed establishing, that the cortical layer during fetus antenatal development is hypoechoic and the medulla is moderately echogenic. It was possible to differentiate the medulla in 100% of cases starting from 30 weeks of gestation age. In 4 cases of adrenal hemorrhage the size and volume of adrenal glands were significantly increased in compare with the physiological pregnancy. Parenchyma echogenicity showed a mixed pattern (un- and hyperechoic). In 3 cases of adrenal hypoplasia the size and volume of adrenal glands were decreased and parenchyma was hypoechoic without cortical layer and medulla differentiation. Multi-Slice View technique was very useful in choosing of the optimal scan for size measurements and adrenal glands structure assessment. Dynamic Magnetic Resonance Imaging technique was applied for image quality and the adrenal glands cortical layer and medulla differentiation improvement in 2D US. The use of new US techniques for fetal adrenal glands visualization, in compare with standard ones, allowed improving the image quality and measurements accuracy.