Right adrenal gland seen ~80% at least once during scan Left adrenal gland seen ~40% at least once during scan UltrasoundĪnterior transverse scanning is the best approach but the adrenal glands are often difficult to see 6: Generally, the size of the adrenal gland should not be thicker than the adjacent crus of diaphragm 11. Often near adrenal glands but may be found anywhere in the abdomen, pelvis or scrotum 9
Often in the presence of a pelvic kidney or renal agenesis Post synaptic fibers from celiac, aorticorenal, and renal ganglia innervate surrounding vessels Presynaptic sympathetic fibers, from thoracic splanchnic nerves synapse directly with chromaffin cells 9 Lymphatics are contained within the capsule and drain to the para-aortic nodes 7,9 May join with the left inferior phrenic vein before entering the left renal vein Left adrenal vein drains to the left renal vein Inferior adrenal artery which arises from the renal arteryĪdrenal veins emerge from the hilum and drain to different veins depending on the side: Often the largest of the adrenal arteries Middle adrenal artery which arises from the abdominal aorta Superior adrenal artery which arises from the inferior phrenic artery The arterial supply is via three adrenal arteries 5: Medial: left crus of the diaphragm, left inferior phrenic arteryĪnterior: lesser sac, stomach, splenic artery, pancreas Lateral: right lobe (bare area) of the liver Medial: right crus of the diaphragm, right inferior phrenic artery The right adrenal gland is lower and more medial to the spine than the left adrenal gland 11. The adrenal glands lie superior and anteromedial to the kidneys 1. The medulla (chromaffin cells) produces catecholamines (epinephrine, norepinephrine) as well as dopamine.
The cortex is subdivided into three zones (from outer to inner) 5,7: The outer cortex is derived by mesoderm while the inner medulla is derived from neural crest cells 11. The gland is covered by a collagenous capsule. The adrenal gland consists of two portions: an outer cortex and an inner medulla. Proportionately, the adrenal size is larger in neonates and infants, being almost one-third of the size of the kidney 2-4. The right adrenal gland has a maximum width of 6.1 mm and the left adrenal gland has a maximum width of 7.9 mm 6. While left adrenal gland is triangular or Y-shaped 1,11. However, the right adrenal gland is usually more pyramidal in shape while the left adrenal gland is more crescentic 7. On cross-section, right adrenal gland is linear, comma or V-shaped with larger medial limb and smaller lateral limb. Each gland is enclosed in the perirenal fascia and each has a body and two limbs: a medial limb and a lateral limb.
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