Abstract
Objectives
This study aimed to identify the incidence of AH after OLT and to summarize the ultrasound (US) and contrast-enhanced ultrasound (CEUS) characteristics.
Methods
Patients with adrenal lesions after OLT at our hospital were retrospectively reviewed between January 2008 and November 2021. The reference diagnosis was defined based on surgical data, computed tomography scans, and magnetic resonance imaging with at least 12 months of follow-up. The incidence of AH and the features of US and CEUS after OLT were analyzed and compared with those of adrenal metastases.
Results
A total of 23 patients (1.2%) with AH and 7 (0.35%) with suprarenal metastases were assessed. Compared with metastases, hematomas had more inhomogeneous echotextures (57% vs. 0.00%, P = 0.010), hypoechoic or mixed-echoic patterns (96% vs. 71%, P = 0.022), and anechoic areas (52% vs. 0.00%, P = 0.024), and their echotexture varied more over time (65% vs. 0.14%, P = 0.031). CEUS was performed in 12 patients with AH and 2 with metastases. Contrast extravasation was observed in one active bleeding hematoma, whereas no enhancement was observed in any static hematoma (100%). However, adrenal metastases appeared contrast-enhanced in the early arterial phase, followed by fast wash-out in the late phase (100%), and the difference was statistically significant (P < 0.001).
Conclusion
The sonographic characteristics of AH after OLT vary over time. CEUS is recommended when adrenal lesions are detected, as CEUS can differentiate AH from metastases.