ArticleEuropean radiology2019
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.
Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 16 citations in OpenAlex.
- Arterial phase enhancement of the adrenal glands as a severity indicator for acute pancreatitis.Japanese journal of radiology · 2025Article
- Multidetector CT Imaging Biomarkers as Predictors of Prognosis in Shock: Updates and Future Directions.Diagnostics (Basel, Switzerland) · 2023Review
- Renal venous density in the arterial phase of contrast-enhanced CT predicts prognosis in septic shock.The British journal of radiology · 2023Article
- Abdominal atherosclerosis is not a risk factor of nonocclusive mesenteric ischemia among critically ill patients: a propensity matching study.Annals of intensive care · 2022Article
- Review
- The Hollow Adrenal Gland Sign: An Ominous Alert.Journal of the Belgian Society of Radiology · 2022Article
- Computed tomography imaging of septic shock. Beyond the cause: the "CT hypoperfusion complex". A pictorial essay.Insights into imaging · 2021Review
- Mapping a mammalian adult adrenal gland hierarchy across species by microwell-seq.Cell regeneration (London, England) · 2020Article
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7 authors at 3 institutions in 1 country.
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Abstract
objectiveTo investigate the incidence, CT appearance, and implication for prognosis of the hollow adrenal gland sign (HAGS).
methodsA 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.
resultsThe 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).
conclusionThe 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.
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