Clinical study
Scintigraphic localization of adrenal lesions in primary aldosteronism

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Abstract

Dexamethasone suppression adrenal cortical scintiscanning was performed in 87 patients with primary aldosteronism. Fifty patients had adrenal cortical adenomas and 37 had bilateral adrenal hyperplasia. The diagnosis of adrenal cortical adenoma was confirmed by surgery in 49 of 50, and bilateral adrenal hyperplasia was confirmed by adrenal vein aldosterone sampling in 33 and at operation in four. Dexamethasone suppression adrenal scintigraphy correctly identified the lesion(s) in 82 of the 87 patients. There were three false-negative and two false-positive adrenal cortical scintiscanning results. Computed tomography was performed in 33 patients and correctly identified 14 of 23 patients with adrenal cortical adenomas and two of 10 patients with bilateral adrenal hyperplasia and bilateral enlarged adrenals, whereas the remaining eight were considered to have normal findings. These data indicate that, when properly performed, adrenal cortical scintigraphy is an accurate and efficacious modality for the localization of adrenal cortical adenomas and in the differentiation of adrenal cortical adenoma from bilateral adrenal hyperplasia in primary aldosteronism.

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    This work was supported by grants from the National Cancer Institute (CA-09015), National Institute of Arthritis, Metabolism, and Digestive Diseases (R01-AM-21477-02RAD), Clinical Research Center (NEW-3M01-RR0042-22 S1 CLR), Nuclear Medicine Research Fund, and the Veterans Administration Research Service.

    1

    From the Divisions of Nuclear Medicine and Endocrinology and Metabolism, Department of Internal Medicine, and the Department of Radiology and Department of Surgery, University of Michigan and Veterans Administration Medical Centers, Ann Arbor, Michigan.

    2

    Dr. Shapiro is the recipient of the National Institutes of Health Clinical Associate Physician Award.

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