Sonographic appearance of adrenal hemorrhage in the neonate

What is the sonographic appearance of adrenal hemorrhage in the neonate, and how can adrenal hemorrhage be differentiated from adrenal neuroblastoma?

Adrenal hemorrhage initially appears as a solid-appearing mass. On serial imaging, adrenal hemorrhage generally decreases in size and changes in appearance from solid to cystic, usually resolving completely over time.

If over time, the adrenal mass remains solid or complex-cystic in appearance or enlarges, adrenal neuroblastoma must be considered. Correlation with serum/urine metanephrines may be helpful in their differentiation as well.


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