title: Clinical impact of hyperattenuation of adrenal glands on contrast-enhanced computed tomography of polytraumatised patients.
abstract: OBJECTIVE
  To evaluate the prognostic value of hyperattenuating adrenal glands on contrast-enhanced CT of polytraumatised patients.
  
  
  METHODS
  Two hundred ninety-two patients (195 men and 97 women, mean age 45.3 ± 23.3 years) were included in this retrospective study. CT examinations were performed 60 s after intravenous injection of contrast material. Image analysis was performed by two radiologists. Patients were assigned to one of two groups according to the attenuation of the adrenal gland [group 1: adrenal glands ≥ inferior vena cava (IVC); group 2: adrenal glands < IVC].
  
  
  RESULTS
  Eighteen patients (42.2 years ± 24.2) were assigned to group 1 and 274 patients (48.4 years ± 22.4) to group 2. The average adrenal density was 150.8 ± 36.1 HU in group 1 and 83.7 ± 23.6 HU in group 2 (P < 0.0001). Eight of the 18 patients in group 1 (44.4%) and 33 of the 274 patients in group 2 (12.4%) died during hospitalisation (P < 0.05). Mean adrenal enhancement was significantly higher in patients who died (101.9 ± 40.6 HU) compared with survivors (86.1 ± 27.0 HU; P < 0.001).
  
  
  CONCLUSIONS
  Hyperattenuation of adrenal glands is associated with a higher mortality rate in polytraumatised patients and may serve as a predictor of poor clinical outcome.
  
  
  CONCLUSIONS
  • Hyperattenuating adrenal glands can be observed in 6.2% of polytraumatised patients. • Hyperattenuating adrenal glands indicate poor clinical outcome in polytraumatised patients. • In polytraumatised patients, hyperattenuating adrenal glands are associated with a high mortality rate. • Adrenal enhancement is higher amongst patients who died than amongst survivors.
authors.affiliation: Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schek
authors.forename: S
authors.initials: S
authors.lastname: Macht
authors.forename: J
authors.initials: J
authors.lastname: Klasen-Sansone
authors.forename: P
authors.initials: P
authors.lastname: Heusch
authors.forename: P
authors.initials: P
authors.lastname: Kröpil
authors.forename: I
authors.initials: I
authors.lastname: Witte
authors.forename: G
authors.initials: G
authors.lastname: Antoch
authors.forename: R S
authors.initials: RS
authors.lastname: Lanzman
mesh_terms: D000293:Adolescent; D000311:Adrenal Glands / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000401:mortality; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media