Sonography for diagnosis and follow-up of neonatal adrenal hemorrhage.

Neonatal adrenal hemorrhage was diagnosed by ultrasound as an echo-free mass superior to downward displaced normal kidneys in three newborns. In one, the adrenal hemorrhage was bilateral. Fine needle aspiration was performed to confirm the diagnosis in one case. The babies were followed-up until adrenal calcifications were seen on ultrasound as linear echoes with posterior acoustic shadowing. These calcifications were confirmed by plain films. It is suggested that the diagnosis of neonatal adrenal hemorrhage should be based on ultrasound and on one initial intravenous urogram. Follow-up examinations should be restricted to ultrasound and plain films. In doubtful cases fine needle aspiration can be added for confirmation.