Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys
<i>Background:</i> non-hemorrhagic adrenal infarction (NHAI) is a rare cause of acute abdominal/flank pain during pregnancy; in order to ensure prompt and appropriate treatment, this diagnosis should not be overlooked. This case series highlights pertinent imaging findings, including ult...
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| Format: | Article |
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MDPI AG
2021-10-01
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| Series: | Tomography |
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| author | Pierre Chagué Antoine Marchi Alix Fechner Ghina Hindawi Hadrien Tranchart Julie Carrara Alexandre J. Vivanti Laurence Rocher |
| author_facet | Pierre Chagué Antoine Marchi Alix Fechner Ghina Hindawi Hadrien Tranchart Julie Carrara Alexandre J. Vivanti Laurence Rocher |
| author_sort | Pierre Chagué |
| collection | DOAJ |
| description | <i>Background:</i> non-hemorrhagic adrenal infarction (NHAI) is a rare cause of acute abdominal/flank pain during pregnancy; in order to ensure prompt and appropriate treatment, this diagnosis should not be overlooked. This case series highlights pertinent imaging findings, including ultrasounds (USs), computed tomography (CT), and magnetic resonance imaging (MRI) of recent NHAI cases.<i> Methods:</i> we compiled all consecutive NHAI cases from two university hospitals over a two-year period and checked the relevant clinical, laboratory, and imaging findings. Relevant articles on NHAI published from January 2010 to March 2021 were analyzed. <i>Results:</i> six cases were found in our database. CT-scans typically showed enlarged, hypodense, and non-enhanced adrenal glands. Unenhanced MRIs allowed for diagnoses and showed enlarged adrenal glands in the signal hyperintensity on T2 and diffusion-weighted imaging, without any signal hyperintensity on T1. In two of our six cases, USs showed swollen adrenal glands with fluid collection. <i>Conclusion:</i> NHAI and its differential diagnosis—in cases of acute pain during pregnancy—highlight the crucial roles of integrated radiological examination and cooperation between obstetricians and radiologists, both of whom should consider the location of the pain, the accessibility and tolerance of MRI, and the radiation exposure of CT. Despite its supposed poor sensitivity, an US performed because the patient reports pain should also be used to examine the adrenal gland regions. Non-enhanced MRI is clearly of value and access to it in emergencies is important to avoid radiation exposure |
| first_indexed | 2024-03-10T03:59:10Z |
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| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-10T03:59:10Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-995621b473ab47b896d300668582684d2023-11-23T10:48:55ZengMDPI AGTomography2379-13812379-139X2021-10-017453354410.3390/tomography7040046Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging KeysPierre Chagué0Antoine Marchi1Alix Fechner2Ghina Hindawi3Hadrien Tranchart4Julie Carrara5Alexandre J. Vivanti6Laurence Rocher7AP-HP, Hôpital Antoine Béclère, Service de Radiologie, 92140 Clamart, FranceAP-HP, Hôpital Antoine Béclère, Service de Radiologie, 92140 Clamart, FranceAP-HP, Hôpital Antoine Béclère, Service de Radiologie, 92140 Clamart, FranceAP-HP, Hôpital Kremlin Bicêtre, Service de Radiologie, 94270 Le Kremlin Bicêtre, FranceFaculté de Médecine Paris-Sud, Université Paris-Saclay, 94270 Le Kremlin Bicêtre, FranceFaculté de Médecine Paris-Sud, Université Paris-Saclay, 94270 Le Kremlin Bicêtre, FranceFaculté de Médecine Paris-Sud, Université Paris-Saclay, 94270 Le Kremlin Bicêtre, FranceAP-HP, Hôpital Antoine Béclère, Service de Radiologie, 92140 Clamart, France<i>Background:</i> non-hemorrhagic adrenal infarction (NHAI) is a rare cause of acute abdominal/flank pain during pregnancy; in order to ensure prompt and appropriate treatment, this diagnosis should not be overlooked. This case series highlights pertinent imaging findings, including ultrasounds (USs), computed tomography (CT), and magnetic resonance imaging (MRI) of recent NHAI cases.<i> Methods:</i> we compiled all consecutive NHAI cases from two university hospitals over a two-year period and checked the relevant clinical, laboratory, and imaging findings. Relevant articles on NHAI published from January 2010 to March 2021 were analyzed. <i>Results:</i> six cases were found in our database. CT-scans typically showed enlarged, hypodense, and non-enhanced adrenal glands. Unenhanced MRIs allowed for diagnoses and showed enlarged adrenal glands in the signal hyperintensity on T2 and diffusion-weighted imaging, without any signal hyperintensity on T1. In two of our six cases, USs showed swollen adrenal glands with fluid collection. <i>Conclusion:</i> NHAI and its differential diagnosis—in cases of acute pain during pregnancy—highlight the crucial roles of integrated radiological examination and cooperation between obstetricians and radiologists, both of whom should consider the location of the pain, the accessibility and tolerance of MRI, and the radiation exposure of CT. Despite its supposed poor sensitivity, an US performed because the patient reports pain should also be used to examine the adrenal gland regions. Non-enhanced MRI is clearly of value and access to it in emergencies is important to avoid radiation exposurehttps://www.mdpi.com/2379-139X/7/4/46adrenal infarctionabdominal pain in pregnancynon-hemorrhagic adrenal infarctionadrenal thrombosisadrenal ischemiaMRI |
| spellingShingle | Pierre Chagué Antoine Marchi Alix Fechner Ghina Hindawi Hadrien Tranchart Julie Carrara Alexandre J. Vivanti Laurence Rocher Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys Tomography adrenal infarction abdominal pain in pregnancy non-hemorrhagic adrenal infarction adrenal thrombosis adrenal ischemia MRI |
| title | Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys |
| title_full | Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys |
| title_fullStr | Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys |
| title_full_unstemmed | Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys |
| title_short | Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys |
| title_sort | non hemorrhagic adrenal infarction during pregnancy the diagnostic imaging keys |
| topic | adrenal infarction abdominal pain in pregnancy non-hemorrhagic adrenal infarction adrenal thrombosis adrenal ischemia MRI |
| url | https://www.mdpi.com/2379-139X/7/4/46 |
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