CT scan of the adrenal glands in Moscow: indications, preparation, price
Adrenal computed tomography (CT) is a highly accurate X-ray imaging technique for layer-by-layer imaging of the adrenal glands with a resolution of up to 1 mm. It allows for the detection, description, and, in most cases, differentiation of space-occupying lesions (adenomas, pheochromocytomas, carcinomas, cysts, metastases), determining their size and relationship to surrounding structures.
The adrenal glands are paired glands located above the upper poles of the kidneys. Despite their small size (up to 3–5 cm), they synthesize cortisol, adrenaline, aldosterone, and androgens—hormones that regulate blood pressure, stress response, and metabolism.
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CT scan with and without contrast: what's the difference?
CT of the adrenal glands is performed using a special washout protocol. This is crucial for differential diagnosis:
- Native phase: assessment of the mass density (HU). Adenomas rich in lipid have low density (<10 HU), allowing for the diagnosis of benign adenomas without contrast.
- Arterial and portal phases: the nature of contrast accumulation.
- Delayed washout phase (15 min): a key parameter. "Rapid washout" (absolute washout >60%, relative washout >40%) is typical of benign adenomas.
Pheochromocytomas, carcinomas, and metastases exhibit delayed washout and other CT features, allowing them to be differentiated from adenomas.
Preparation for CT scan of the adrenal glands
When examined without contrast
- No special preparation required
- Remove metal jewelry and electronic devices
When examined with contrast enhancement
- Eat your last meal 4–6 hours before the test.
- Drink 500 ml of water 1 hour before (to fill the gastrointestinal tract).
- Metformin: If you are taking metformin (a drug for type 2 diabetes), stop taking it 48 hours before the test and resume it no earlier than 48 hours after to avoid the risk of lactic acidosis.
- Allergy history: Tell your doctor if you have had any previous reactions to iodine-containing medications or seafood.
- Renal function: If renal dysfunction is suspected, a creatinine test (calculation of SCF) is performed before contrast.
General information
Contraindications
Absolute (for contrast):
- History of severe allergy to iodine-containing contrast agents
- CKD with SCF < 30 ml/min/1.73 m²
Relative:
- Pregnancy (risk/benefit assessment)
- Thyrotoxicosis (the contrast medium contains iodine – may provoke thyroid storm; prior consultation with an endocrinologist is mandatory)
For pheochromocytoma (or suspected thereof): contrast should be administered only after preoperative alpha-adrenergic blockade – administration of contrast without blockade can provoke a hypertensive crisis. Notify the radiologist of any suspected pheochromocytoma prior to the examination.
FAQ
What is an adrenal incidentaloma?
Is a CT scan with contrast dangerous?
Can the adrenal glands be invisible on a standard ultrasound?
Why is a washout protocol necessary?
Is an adrenal biopsy necessary if a mass is detected?
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Indications for CT scan of the adrenal glands
Main indications: