Aley Talans MD, Presenter: Nothing to Disclose

Suely Fazio Ferraciolli, Abstract Co-Author: Nothing to Disclose

Viviane Sayuri Yamachira, Abstract Co-Author: Nothing to Disclose

Natally de Souza Maciel Rocha Horvat MD, Abstract Co-Author: Nothing to Disclose

Hilton M. Leao Filho MD, Abstract Co-Author: Nothing to Disclose

Ronaldo Hueb Baroni MD, Abstract Co-Author: Nothing to Disclose

To demonstrate the spectrum of adrenal CT findings commonly found postmortem, and to correlate imaging features and histological findings.

We retrospectively evaluated 61 corpses who underwent postmortem CT scans, and compare them to pathological and histological findings in conventional autopsy. Abdominal CT scans were performed with intra-arterial and intravenous iodinated contrast injection in 50 corpses. Radiologic-pathological correlation was performed.  

The average elapsed time between the CT scans and time of death was 11.3 hours. The mean attenuation was 27 HU (ranging from 4 HU to 48 HU), and 53% of the glands showed post contrast enhancement (considering the 50 corpses who were submitted to pre and post contrast phases). Gas within the gland was found in 12.3% of the cases. Calcification was found in 4,0% (5 / 122). Nodules were detected in 4% (5 / 122 of the CT scans. The histological findings were: no pathological finding in 67% (41/61), hemorrhage in 11.5% (7/61), ischemia and/or necrosis in 13% (8/61), nodules in 3.3% (4/122), microscopic metastatic lesions in 5% (3/61), macroscopic metastatic lesions in 1.6% (1/61). Histological correlation revealed that four of the 5 nodules seen on CT images had concordant pathological findings (2 metastasis of colonic adenocarcinoma and 2 metastasis of gastric adenocarcinoma). All these nodules had attenuation > 10 HU on CT (range 23-30). CT was not able to detect image alterations in glands with microscopic lesions. Despite the fact that we found 11.5% of adrenal glands with hemorrhage on autopsy, there was no significant difference in the mean attenuation of these glands when compared to the control group (31 HU and 27 HU, respectively). Considering the 28 corpses with post contrast enhancement, only 9 (32%) showed ischemia or hemorrhage on autopsy. Only 1 of the 15 corpses that presented gas on the CT had ischemia and/or necrosis on the autopsy.  

Our study found some concordances and some differences between imaging and histological findings of postmortem adrenal glands. Further studies are been held to elucidate those questions since virtual autopsy is a potential alternative to conventional autopsy.

To associate the adrenal gland alterations found on virtual autopsy with conventional autopsy, providing a radiological-pathological correlation.

Talans, A, Ferraciolli, S, Yamachira, V, Horvat, N, Leao Filho, H, Baroni, R, Postmortem Adrenal Glands: CT Findings.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002904.html