The appearance of the adrenal glands on computed tomography in multiple endocrine neoplasia type 1.
OBJECTIVE
To review the morphology of the adrenal glands in multiple endocrine neoplasia type 1 (MEN1) on computed tomography (CT) to compare the results with established normal values for adrenal size and nodularity and to correlate adrenal size with serum cortisol secretory dynamics.


METHODS
Two observers independently reviewed the adrenal CT in 28 patients with MEN1, measuring the maximum width of the body of the gland and the medial and lateral limbs. Incidence and location of nodules >5 mm within the gland were recorded. Following exclusion of known cases of Cushing's syndrome, adrenal gland size was compared with previously documented normative data. Adrenal gland size was compared between patients with normal and abnormal cortisol dynamics.


RESULTS
Comparison of mean adrenal size in MEN1 patients with normative data showed that the adrenal limbs were significantly larger in MEN1 than normal (P<0.0001 in all four limbs). Adrenal body was also significantly larger (P<0.05). Nodules were demonstrated in 17 (60%) of patients (versus 0.4-2% in the normal population). No statistically significant correlation was demonstrated between adrenal limb hyperplasia and abnormal cortisol dynamics.


CONCLUSIONS
In patients with MEN1, adrenal limb hyperplasia and adrenal nodules are significantly more common than in the normal population, a phenomenon not previously documented in a quantitative manner. There was no significant correlation between adrenal limb hyperplasia and abnormal cortisol dynamics.
Whitley
S A
SA
Department of Diagnostic Imaging, St Bartholomew's Hospital, Barts and the London NHS Trust and QMUL, London, UK.
Moyes
V J
VJ
Park
K M
KM
Brooke
A M
AM
Grossman
A B
AB
Chew
S L
SL
Rockall
A G
AG
Monson
J P
JP
Reznek
R H
RH
D000311:Adrenal Glands / Q000000981:diagnostic imaging* / Q000187:drug effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
D003907:Dexamethasone; D006854:Hydrocortisone