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Image diagnosis of adrenal disorders 1. computed tomographic images of control subjects and image diagnosis of primary aldosteronism


, : Image diagnosis of adrenal disorders 1. computed tomographic images of control subjects and image diagnosis of primary aldosteronism. Folia Endocrinologica Japonica 61(2): 97-111

The shape and size of the adrenals in control subjects without adrenal disorders were studied by computed tomography (CT); a comparative assessment of diagnostic values of ultrasonography (US) by electronic linear scanner, CT and adrenal scintigraphy was made on 9 patients with primary aldosteronism. Adrenal imaging by scintigraphy was performed on the 5th and 6th day, or further on the 7th day after the injection of 1 mCi [curies] of Adosterol. Eighty-two percent of 100 control right adrenals; 89% of 100 control left adrenals were detected by CT. Seventy-seven percent of the right adrenals were in linear-shape; the others were in V-shape. The shape of the left adrenals could be classified into triangular-shape (54%), Y-shape (28%) and V-shape (18%). The mean width and thickness of the right adrenals were 28.6 .+-. 7.5 mm (M .+-. SD) and 3.8 .+-. 1.4 mm, respectively. Those of the left ones were 19.4 .+-. 5.5 mm and 5.3 .+-. 1.8 mm. In 2 out of 3 patients examined by US, aldosteronomas were detected. In these 2 patients, 1 had 2 adenomas 2.8 .times. 1.7 .times. 1.2 cm and 1.0 .times. 2.0 cm in size; the other had 1 adenoma 0.8 .times. 1.0 .times. 2.0 cm in size. On adrenal scintiscanning under dexamethasone pretreatment (DP), the isotope uptake of aldosteronoma was still seen with the disappearance of the contralateral adrenal in 7 out of 9 cases. In these 7 cases, the laterality of the tumor was confirmed. In 1 of the remaining 2 cases, the bilateral adrenal images were obtained regardless of DP. In the other cases, of which aldosteronoma was the smallest (0.6 .times. 0.6 .times. 0.8 cm), the image of the affected adrenal with adenoma as well as the contralateral adrenal disappeared under DP. CT delineated all aldosteronomas in 8 cases examined including 2 cases in which adrenal scintiscanning failed to elucidate the localization of aldosteronoma. Apparently, the combination of these 3 new image diagnostic methods was available for the detection of aldosteronomas of various sizes.

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