Roseland Molly E, Zhang Man, Caoili Elaine M
Department of Radiology, Michigan Medicine, 1500. E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Rev Endocr Metab Disord. 2023 Feb;24(1):97-106. doi: 10.1007/s11154-022-09733-w. Epub 2022 May 27.
A high level of clinical suspicion is essential in the diagnosis and management of a suspected adrenal mass during pregnancy and the peripartum period. Timely recognition is important in order to improve fetal and maternal outcomes. Imaging is often performed to confirm a suspected adrenal lesion; however, increasing usage of diagnostic imaging during pregnancy and lactation has also increased awareness, concerns and confusion regarding the safety risks regarding fetal and maternal exposure to radiation and imaging intravenous contrast agents. This may lead to anxiety and avoidance of imaging examinations which can delay diagnosis and appropriate treatment. This article briefly reviews evidence-based recommended imaging modalities during pregnancy and the lactation period for the assessment of a suspected adrenal mass while recognizing that no examination should be withheld when the exam is necessary to confirm an important clinical suspicion. The imaging characteristics of the more common adrenal pathologies that may affect pregnant women are also discussed.
在孕期和围产期对疑似肾上腺肿块进行诊断和管理时，高度的临床怀疑至关重要。及时识别对于改善胎儿和母亲的结局很重要。通常会进行影像学检查以确认疑似肾上腺病变；然而，孕期和哺乳期诊断性影像学检查的使用增加，也提高了人们对胎儿和母亲暴露于辐射及影像学静脉造影剂的安全风险的认识、担忧和困惑。这可能导致焦虑并避免进行影像学检查，从而延误诊断和适当治疗。本文简要回顾了基于证据的孕期和哺乳期评估疑似肾上腺肿块的推荐影像学检查方法，同时认识到当有必要确认重要的临床怀疑时，不应省略任何检查。本文还讨论了可能影响孕妇的较常见肾上腺病变的影像学特征。
