Diagnosis of primary hyperaldosteronism: importance of correlating CT findings with endocrinologic studies
| Autor: | D R Radin, C Manoogian, J L Nadler |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Adenoma
Adult Male Pathology medicine.medical_specialty chemistry.chemical_compound Adrenal Glands Hyperaldosteronism medicine Humans Radiology Nuclear Medicine and imaging 18-Hydroxycorticosterone Aldosterone Aged Hyperplasia Adrenal cortex business.industry Adrenal gland Adrenal Scintigraphy Nodule (medicine) General Medicine Middle Aged medicine.disease Adrenal Cortex Neoplasms medicine.anatomical_structure chemistry Female Radiology medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | American Journal of Roentgenology. 158:553-557 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | Twenty patients with primary hyperaldosteronism had endocrinologic and radiologic studies to distinguish aldosterone-producing adenoma from idiopathic hyperaldosteronism due to bilateral micro- or macronodular hyperplasia of the adrenal cortex. In addition to examination for changes in the plasma level of aldosterone associated with postural changes and measurement of the plasma level of 18-hydroxycorticosterone, all 20 patients had CT examination of the adrenal glands. In three patients with normal adrenal glands on CT and three patients with CT evidence of two solitary nodules, one in each adrenal gland, a diagnosis of idiopathic hyperaldosteronism was confirmed by endocrinologic findings (five patients) or 131I-6 beta-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy (one patient). In nine patients with a solitary adrenal nodule on CT, a diagnosis of aldosterone-producing adenoma was confirmed by surgery (seven patients) or hormone sampling via the adrenal veins (two patients). However, in three patients with a solitary adrenal nodule on CT, a diagnosis of idiopathic hyperaldosteronism was suggested by endocrinologic findings (three patients) and confirmed by the results of NP-59 scintigraphy (two patients) or adrenal venous sampling (one patient). In addition, in two patients with CT evidence of three adrenal nodules (two in one gland, one in contralateral gland), a diagnosis of aldosterone-producing adenoma was suggested by endocrinologic findings in both patients and confirmed by surgery in one. Although high-resolution CT is highly accurate for the detection of aldosterone-producing adenoma, significant diagnostic errors can occur in patients with primary hyperaldosteronism if CT findings are not correlated with results of endocrinologic studies. |
| Databáze: | OpenAIRE |
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