AP-HP, Hôpital Antoine Béclère, Service de Radiologie, 92140 Clamart, France.
Faculté de Médecine Paris-Sud, Université Paris-Saclay, 94270 Le Kremlin Bicêtre, France.
Tomography. 2021 Oct 6;7(4):533-544. doi: 10.3390/tomography7040046.
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. 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. 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. 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.
非出血性肾上腺梗死（NHAI）是妊娠期间急性腹痛/侧腹痛的罕见原因；为确保及时和适当的治疗，不应忽视这一诊断。本病例系列强调了相关的影像学表现，包括最近的 NHAI 病例的超声（US）、计算机断层扫描（CT）和磁共振成像（MRI）。我们从两所大学医院的数据库中收集了过去两年中所有连续的 NHAI 病例，并检查了相关的临床、实验室和影像学表现。分析了 2010 年 1 月至 2021 年 3 月发表的关于 NHAI 的相关文章。我们的数据库中发现了 6 例病例。CT 扫描通常显示增大、低密、非增强的肾上腺。未增强的 MRI 可以进行诊断，并显示 T2 和扩散加权成像上信号增强的增大肾上腺，T1 上没有任何信号增强。在我们的 6 例病例中的 2 例中，US 显示肿胀的肾上腺有液体聚集。NHAI 及其在妊娠期间急性疼痛情况下的鉴别诊断突显了综合影像学检查和妇产科医生与放射科医生之间合作的关键作用，两者都应考虑疼痛的位置、MRI 的可及性和耐受性以及 CT 的辐射暴露。尽管 US 的敏感性较低，但由于患者报告疼痛而进行的 US 检查也应用于检查肾上腺区域。非增强 MRI 显然具有价值，在紧急情况下获得 MRI 对于避免辐射暴露很重要。
