Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;29(10):5378-5385.
doi: 10.1007/s00330-019-06172-1. Epub 2019 Apr 1.

The hollow adrenal gland sign: a newly described enhancing pattern of the adrenal gland on dual-phase contrast-enhanced CT for predicting the prognosis of patients with septic shock

Yang Peng  1 , Qiuxia Xie  2 , Huanjun Wang  1 , Zhi Lin  1 , Fan Zhang  1 , Xuhui Zhou  3 , Jian Guan  4
Affiliations

The hollow adrenal gland sign: a newly described enhancing pattern of the adrenal gland on dual-phase contrast-enhanced CT for predicting the prognosis of patients with septic shock

Yang Peng et al. Eur Radiol. 2019 Oct.

Abstract

Objective: To investigate the incidence, CT appearance, and implication for prognosis of the hollow adrenal gland sign (HAGS).

Methods: A total of 194 patients with septic shock and 24 patients with hemorrhagic shock (as control group) were retrospectively included in this study and the patients with septic shock were further divided into four subgroups (digestive tract diseases, DTD, n = 49; biliary and pancreatic diseases, BPD, n = 41; postsurgical infection, PI, n = 64; and other diseases, OD, n = 40). All patients underwent a dual-phase contrast-enhanced CT within 1 week after diagnosis. CT findings and clinical records were reviewed. If in the arterial phase the central zone of adrenal gland showed temporally much lower attenuation than the peripheral zone, it was defined as HAGS positive. The incidence of the HAGS in patients with septic shock and hemorrhagic shock, the demographic features, and mortality between HAGS-positive and HAGS-negative patients in each group were respectively compared.

Results: The incidence of the HAGS in the septic shock group was nearly 30%, while it was 0 in the hemorrhagic shock group. There was no significant difference in age or gender between HAGS-positive and HAGS-negative patients in all groups, while the mortality of HAGS-positive patients was significantly higher than that of HAGS-negative patients in each group (p < 0.05). The concordance correlation coefficient value showed excellent reproducibility of the two observers (κ = 0.977).

Conclusion: The HAGS is specific and common on dual-phase contrast-enhanced CT in patients with septic shock and predicts a poor prognosis.

Key points: • The hollow adrenal gland sign (HAGS) newly described in this study is a special enhancing pattern of adrenal gland on dual-phase contrast-enhanced CT in patients with septic shock. • The HAGS is characterized by the much lower-attenuated central zone of the adrenal gland in arterial phase and it showed excellent reproducibility between different observers. • The HAGS is specific and common on dual-phase contrast-enhanced CT in patients with septic shock and predicts a poor prognosis.

Keywords: Prognosis; Retrospective studies; Shock, hemorrhagic; Shock, septic; Tomography, X-ray computed.

PubMed Disclaimer

References

    1. Cytokine Growth Factor Rev. 2017 Jun;35:85-96 - PubMed
    1. Eur Radiol. 2010 Oct;20(10):2348-57 - PubMed
    1. Mol Cell Endocrinol. 2015 Jun 15;408:241-8 - PubMed
    1. Anesthesiology. 2011 Aug;115(2):334-43 - PubMed
    1. N Engl J Med. 1995 May 18;332(20):1351-62 - PubMed

LinkOut - more resources