Imaging of the adrenal gland in children

Ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging have replaced intravenous urography and angiography in evaluation of children with suspected disease of the adrenal glands. Although the spatial resolution of MR imaging is still somewhat inferior to that of CT, it allows tissue characterization and better evaluation of tumor extension owing to its multiplanar imaging capability. Initial diagnosis of an adrenal mass in a child is made with US, which is also used to document regression of uncomplicated neonatal adrenal hemorrhage. MR imaging is used for evaluation of tumor extension when surgery is to be performed. Imaging findings such as size, shape, and signal intensity are often not specific for a pathologic condition and must be interpreted in conjunction with the patient's age, the clinical history (eg, trauma), results of physical examination (eg, palpable mass or presence of an endocrine syndrome), and hormone levels in blood and urine.