Radioanatomy of the

Endocrine Glands
What are endocrine glands?
 Glands that produce hormones and
secrete them directly in the blood
stream
 They do not have ducts
– Pituitary
– Thyroid
– Parathyroid
– Adrenals
– Pancreas
Pituitary Gland
 Pituitary Gland
 Master gland of the endocrine system
 Lies in the hypophyseal fossa (sella
turcica)
 Fossa is roofed by diaphragma sellae
 Stalk of the hypophysis cerebri pierces
the diaphragma sellae and is attached
above to the floor of the third ventricle
 Pituitary Gland
 Glandis oval in shape
 Measures 8 mm (AP diameter) and
12 mm (transversely)
 Weighs 500 mg
 Relations
 Superiorly
– Diaphragma sellae
– Optic chiasma
– Tuber cinerium
– Infundibular recess of 3rd ventricle
 Inferiorly
– Hypophyseal fossa and irregular venous
channels between the two layers of dura
covering it
– Sphenoidal air sinuses
 On each side
– Cavernous sinus with its contents
 Subdivisions
 Adenohypophysis
– Anterior lobe
– Intermediate lobe
– Tuberal lobe
 Neurohypophysis
– Posterior lobe
– Infundibular stem
– Median eminence of the tuber cinerium
 Blood Supply
 Arterial
– Branches of internal carotid artery
 Veins
– Short veins emerge on the surface of
the gland and drain into the
neighbouring venous sinuses
 Radio-Imaging of Pituitary
Gland
 Not visualized on Plain X-Ray of the
skull, except for the sella turcica and
clinoid processes – housing the
pituitary gland
 Visualized on
– CT Scan of brain
– MRI of brain
– PET Scan of brain
Radiograph of Skull
 Lateral view shows
the sella turcica
 Pituitary gland
resides on top of the
sella turcica
 The anterior and
posterior clinoid
processes define the
anterior and posterior
boundaries
Radiograph of Skull
 Towne’s View
shows dorsum
sellae on top of
which lies the
pituitary gland
A. Frontal Lobe
B. Frontal Bone (Superior
Surface of Orbital Part)
C. Dorsum Sellae
D. Basilar Artery
E. Temporal Lobe
F. Mastoid Air Cells
G. Cerebellar Hemisphere CT Scan of
Head
MRI of Brain
MRI
of
Brai
n
MRI of Brain
MRI of Brain
Pituitary
Gland
Pituitary Gland
Sella
turcica
Normal
Optic
Chiasm
Pituitary
Adenoma
 Optic
nerves

Pituitary
Adenom
a
Thyroid Gland
Endocrine Gland
• regulates basal
metabolic rate
• stimulates
somatic and psychic
growth
• plays important
role in calcium
metabolism
Ultrasound of Thyroid Gland
 Thyroid Gland
 Two lobes joined by the
isthmus
 Lies against the C5,C6, C7
and T1 vertebrae clasping
the upper part of trachea
 Each lobe extends from
the middle of the thyroid
cartilage to the 4th or 5th
tracheal ring
 Isthmus extends from 2nd
to 3rd tracheal rings
 Thyroid Gland
 Lobes measure about 5 cm x 2.5 cm
x 2.5 cm
 Isthmus measures about 1.2 cm x
1.2 cm
 Larger in females than in males
 Increases in size during menstruation
and pregnancy
 Capsules
 True – peripheral condensation of
connective tissue of the gland
 False – derived from pretracheal
layers of deep cervical fascia
 False capsule forms the suspensory
ligament of Berry which connects the
lobe to the cricoid cartilage
 A dense capillary plexus is present
deep to the true capsule
 Relations
 Lobes are conical in shape and have
– Apex
– Base
– Three surfaces – lateral, medial and
posterolateral
– Two borders – anterior and posterior
 Relations
 Lateral surfaces
– Convex
– Covered by – sternothyhyoid,
sternohyoid, superior belly of omohyoid
and anterior border of sternomastoid
muscles
 Relations
 Medial surface
– Two tubes – trachea and esophagus
– Two muscles – inferior constrictor and
cricothyroid
– Two nerves – extrenal laryngeal and
recurrent laryngeal
 Relations
 Posterolateral surface
– Carotid sheath
– Overlaps common carotid artery
 Relations
 Anterior border
– Thin
– Anterior branch of superior thyroid artery
 Posterior border
– Thick
– Inferior thyroid artery
– Anastomosis between superior and inferior
thyroid artery
– Parathyroid gland
– Thoracic duct (left side)
 Relations
 Apex
– Directed upwards
 Base
 At the level of 4th or 5th tracheal ring
 Relations
 Isthmus
– Connects the lower parts of the lobes
– Two surfaces –
 Anterior and posterior surfaces
– Two borders
 Superior and inferior borders
 Isthmus

 Anterior surface covered by

– Sternothyroid and sternohyoid muscles
(R&L)
– Anterior jugular veins
– Fascia and skin
 Posterior surface related to
– 2nd and 3rd tracheal rings
 Isthmus

 Upper border
– Anastomosis between Right and Left
Superior Thyroid Arteries
 Lower border
– Inferior thyroid veins leave the gland at
this border
 Blood Supply
 Arterial
– Superior thyroid artery – branch of
external carotid artery
– Inferior thyroid artery – branch of
thyrocervical trunk
 Veinous
– Superior thyroid vein
– Inferior thyroid vein
 Radio-Imaging of Thyroid
Gland
 Not visualized on Plain X-Ray unless
calcified
 Visualized on
– Ultrasound
– CT scan
– MRI
– Nuclear Medicine study
Coned apical radiograph of the upper
thorax shows curvilinear calcification
in a thyroid adenoma, at the root of
the neck, on the right side
 Stenohyoid and Isthmus
sternothyroid
muscles

Trachea
Carotid
Artery

Thyroid Gland
Transverse Section of the Right Lobe of Thyroid
Gland
Sagittal Section Transverse
of the Thyroid section of Thyroid
Gland Gland
 Isthmus

Transver
se
Section Trachea

of the
Thyroid
Gland

Left Lobe
Right Lobe
CT Scan of Thyroid Gland
Thyroid Scanning – Nuclear
Medicine
Thyroid Scanning – Nuclear Medicine
Parathyroid Gland
 Parathyroid Gland
 Two pairs
– Superior
– Inferior
 Lieon the posterior border of the thyroid
gland within the thyroid capsule
 Oval or lentiform in shape
 Measure about 6 x 4 x 2 mm
 Weighs 50 mg
 Parathyroid Gland
 Anastomotic artery between superior
and inferior thyroid artery is a good
marker because they lie close to it
 Superior parathyroid glands are more
consistent in location near the
middle of the posterior border of the
thyroid lobe
 Blood Supply
 Arterial
– Inferior thyroid artery
– Anastomosis between superior and
inferior thyroid arteries
 Veinous
– Thyroid veins
 Radio-Imaging
 Not visualized on normal studies
 Seen mostly when there is adenoma
 Sometimes may be ectopic in
location
Transverse and longitudinal views
of the left parathyroid gland
 Immediate
scan Delayed scans

Nonspecific accumulation of
radioactivity in the region of the
parathyroids
A 1.3 x 1.0 cm. nodule, relatively
hyperintense is seen posterior to the left lobe
of the thyroid gland and lateral to the
esophagus.
Injection of radioactive
material shows rapid
uptake by the thyroid
gland

Delayed image
shows a retention of
the radioactive
material at the
inferior pole of the
left thyroid –
parathyroid
Adrenal Glands
 Adrenal Glands
A pair of glands
 Lie in the epigastium at the upper
pole of the kidneys
 In front of the crus of diaphragm
 Opposite the vertebral end of the 11th
intercostal space and 12th rib
 Adrenal Glands
 Right adrenal gland is triangular or
pyramidal in shape
 Left adrenal gland is semilunar
 Measures about 50 mm in height, 30 mm
in breadth and 10 mm in thickness
 1/3rd the size of kidneys in children and
1/30th the size in adults
 Weighs 5 g
 Right Adrenal Gland
 An apex
 A base
 Two surfaces – anterior and posterior
 Three borders – anterior, medial and
lateral
 Relations
 Anterior surface – devoid of peritoneum
except a small part below
– Inferior vena cava medially
– Liver laterally and
– Occasionally duodenum inferiorly
 Posterior surface
– Crus of diaphragm
 Anterior border
– Hilum where veins emerge below the apex
 Medial border
– Right celiac ganglion
– Right inferior phrenic artery
 Left Adrenal Gland
 Two ends –
– Upper narrow end
– Lower rounded end
 Two borders
– Medial – convex
– Lateral – concave
 Two surfaces
– Anterior
– Posterior
 Relations
 Anterior surface –
– cardiac end of stomach
– Splenic artery
– Pancreas
 Posterior surface
– Kidney laterally
– Left crus of diaphragm medially
 Medial border
– Left celiac ganglion
– Left inferior phrenic artery
– Left gastric artery
 Blood Supply
 Arterial
– Superior adrenal artery – branch of
inferior phrenic artery
– Middle adrenal artery – branch of
abdominal aorta
– Inferior adrenal artery – branch of renal
artery
 Blood Supply
 Veinous
– Each gland drained by one vein
– Right adrenal vein drains into inferior
vena cava
– Left adrenal vein drains into left renal
vein
 Radio-Imaging
 Not seen on plain X-Ray unless
calcifications are present
 Visualized by
– CT Scan
– MRI
– Ultrasonography – seen better in
children than in adults
Imaging of Adrenal Glands

Located in the perirenal space near the upper pole of

each kidney
They may be shaped like the letters H, L, Y, T, or V
They are less than 4 cm in length and less than 1.0 cm
in thickness
 CT Scan

They may be shaped like the letters H, L, Y, T, or V

 Pancreas

IVC
Spleen
and
Splenic
Vessels

Crus of diaphragm
 Ultrasound of adrenal
mass
 Oblique sagittal image
of the abdomen
demonstrates an
isoechoic mass of the
left adrenal gland that
is anterolateral to the
aorta and medial to
the left kidney
Right
Adrenal
Adenoma
Pancreas 
 Pancreas
 Exocrine gland
– Secretes digestive enzymes
 Endocrine gland
– Secretes hormones like insulin
 The pancreas is 12-15 cm long and is
located in the epigastrium
 Parts of the pancreas: 
– Head
– Uncinate process 
– Neck
– Body
– Tail 
 The head and body lie outside the
peritoneum
 The head of the pancreas is surrounded by
the duodenum as it makes a C-loop
around the pancreas 
 The common bile duct traverses
through the head of the pancreas and
joins with the pancreatic duct at the
ampulla of Vater to empty bile into the
second or descending part of the
duodenum 
 Both the pancreatic ducts of Santorini
and Wirsung drain the exocrine
pancreas 
Relationship to Surrounding
Structures
– Head
 Posterior
– Superior Mesenteric Vein
– Splenic vein
– Inferior Vena Cava
– Terminal portion of renal vein
– Right crus of diaphragm
 Anterior
– Transverse colon
 Lateral
– Bile duct
Relationship to Surrounding
Structures
– Neck
 Anterior
– Pylorus
– Omental bursa
 Posterior
– SMV
– Beginning of portal vein
Relationship to Surrounding
Structures
– Body
 Anterior
– Stomach separated by omental bursa
 Posterior
– Aorta and SMA
– Left crus of diaphragm
– Left kidney and adrenal gland
– Left renal vein and splenic vein
 Inferior
– Transverse mesocolon and splenic
flexure
– Duodeno-jejunal junction
Relationship to Surrounding
Structures
– Tail
 The tail of the pancreas lies in the
splenorenal ligament and enters the
hilum of the spleen with splenic
vessels
Have a Good Day