The use of ultrasonographic adrenal dimensions and the adrenal dimension-to-aorta ratio in the diagnosis of benign and malignant adrenal diseases in dogs

Abstract

Background and aim: Ultrasound (US) is a useful tool for detecting adrenal abnormalities. However, a definite reference range differentiating normal and diseased adrenal glands in dogs of varying body sizes is still lacking. The organ dimension-to-aorta (Ao) ratio of the dogs is correlated with their body weight (BW). Therefore, this study aimed to investigate the adrenal dimensions, including adrenal pole thickness and adrenal length, as well as the adrenal dimension-to-Ao ratio, to differentiate between dogs with normal, benign lesions such as pituitary-dependent hyperadrenocorticism (PDH) and malignant invasive adrenal tumors.

Materials and methods: The medical records and US images of 39 dogs that were either normal (normal) (n = 15) or affected by PDH (n = 15) or malignant invasive adrenal tumors (tumor) (n = 9) were retrieved in this study. All the dogs had a transabdominal US on the sagittal plane. The adrenal dimensions and luminal Ao diameter at the peak of the systolic phase were recorded. The average adrenal dimensions, including the adrenal dimension-to-Ao ratio, were compared among the groups.

Results: Most of the dogs in each group were small-breed dogs with comparable ages, BW, and Ao values. Both adrenal dimensions and the adrenal dimension-to-Ao ratio were significantly lower in the normal group than in the PDH and tumor groups. To differentiate the PDH group from the tumor group, adrenal dimensions of pole thickness and length were more appropriate than the adrenal dimension-to-Ao ratio.

Conclusion: Adrenal dimensions and the adrenal dimension-to-Ao ratio can be used to diagnose adrenal diseases. However, in small-breed dogs, adrenal dimensions are suitable for differentiating PDH from tumor groups. Further research is required with a larger sample size and a wider range of canine body sizes.

Keywords: adrenal; aorta; dogs; hyperadrenocorticism; tumor; ultrasound.

Figure-1

Ultrasonographic image of the mid-abdominal aorta. The internal aortic luminal diameter was measured at the mid-abdominal aorta caudally to the left renal artery root during the peak systolic phase (arrow).

Figure-2

(a) Ultrasound images of the adrenal glands showing the appearances among normal adrenal gland, (b) pituitary-dependent hyperadrenocorticism, (c) malignant, invasive adrenal tumor that (d) includes the intravasation pattern.