Kistner Anna, Kekonius Lisa, Calissendorf Jan, Koskinen Seppo, Falhammar Henrik
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Department of Nuclear Medicine and Medical Physics,, Karolinska University Hospital, Stockholm, Sweden.
Endocrine. 2025 Jun 21. doi: 10.1007/s12020-025-04321-9.
Most adrenal lesions are less than 2 cm and can easily be ignored during primary review of computed tomography (CT)-scans with another question. Furthermore, adrenal lesions, including adrenal hematomas, can easily be missed in patients with multitrauma. We aimed to determine the incidence of adrenal lesions in patients with multitrauma.
This retrospective, single-center cohort analysis included 1373 patients with multitrauma (71.2% males) with a mean age of 42 (95%CI 41-43) years. One radiologist re-examined all multitrauma CT performed 2013-2017 using thin sliced imaging in at least two depictions. A second radiologist re-examined patients where an abnormality was found. Adrenal abnormalities were labelled adrenal lesions (size ≥10 mm) or hematomas, respectively. Clinical data were collected.
The adrenal lesion prevalence was 2.7% (37/1373, 78% males, 22% bilateral). Of these 27% (10/37) were mentioned in the radiological report, and in those with a size ≥15 mm (n = 13), 38% (5/13) were mentioned. Of the unilateral adrenal lesions 86% (25/29) were left-sided. In the adrenal lesion group during the mean follow-up time of 75 (61-90) months none had surgery, 6% had hormones measured (all normal), and 7% had repeated adrenal imaging. The adrenal hematoma prevalence was 5.0% (68/1373, 10% bilateral). No patient had both an adrenal hematoma and an adrenal lesion. Of the unilateral hematomas 42% (26/62) were not mentioned. Of the hematomas 77% were right-sided. No patient with adrenal abnormalities had signs of adrenal insufficiency. 30-day survival rates in the adrenal lesion and hematomas groups were similar, but the hematoma group had higher injury severity score, but no longer length of hospital stay.
The prevalence of adrenal tumors was 2.7% and adrenal hematomas 5.0%. Most lesions were not mentioned in the image report. Few had hormonal evaluation or adrenal imaging follow-up. Survival rates were similar between the two groups.
大多数肾上腺病变小于2厘米，在初次查看计算机断层扫描（CT）时很容易被忽略，还有其他问题。此外，包括肾上腺血肿在内的肾上腺病变在多发伤患者中很容易被漏诊。我们旨在确定多发伤患者肾上腺病变的发生率。
这项回顾性单中心队列分析纳入了1373例多发伤患者（男性占71.2%），平均年龄42岁（95%CI 41 - 43）。一名放射科医生对2013年至2017年进行的所有多发伤CT进行复查，采用薄层成像，至少在两个层面进行观察。第二名放射科医生对发现异常的患者进行复查。肾上腺异常分别标记为肾上腺病变（大小≥10毫米）或血肿。收集临床数据。
肾上腺病变患病率为2.7%（37/1373，男性占78%，双侧病变占22%）。其中27%（10/37）在放射学报告中被提及，在大小≥15毫米的患者中（n = 13），38%（5/13）被提及。单侧肾上腺病变中86%（25/29）位于左侧。在肾上腺病变组，平均随访时间75（61 - 90）个月，无人接受手术，6%进行了激素检测（均正常），7%进行了肾上腺成像复查。肾上腺血肿患病率为5.0%（68/1373，双侧占10%）。没有患者同时患有肾上腺血肿和肾上腺病变。单侧血肿中有42%（26/62）未被提及。血肿中77%位于右侧。肾上腺异常患者均无肾上腺功能不全的体征。肾上腺病变组和血肿组的30天生存率相似，但血肿组损伤严重程度评分更高，但住院时间并未更长。
肾上腺肿瘤患病率为2.7%，肾上腺血肿患病率为5.0%。大多数病变在影像报告中未被提及。很少有人进行激素评估或肾上腺成像随访。两组生存率相似。
