Primary Aldosteronism: Computerized Tomography in Preoperative Evaluation

Pw, Balkin; Jw, Hollifield; Sd, Winn; Mi, Shaff

doi:10.1097/00007611-198509000-00012

Cited by 12 publications

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“…In practice, many patients do not demonstrate circadian falls in PFC, manifest the classic responses of PAC and 18-OH-B to provocative testing, or have low PAC or 18-OH-B values. Sensitivity and specificity of CT in hyperaldosteronism ranges from 48 -58% and 91-92%, respectively (16). Evaluation with either CT or magnetic resonance imaging is performed to assess the presence of small, solitary, unilateral adrenal masses that are highly suggestive of an APA (13,14).…”

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confidence: 99%

Predictive Value of Preoperative Tests in Discriminating Bilateral Adrenal Hyperplasia from an Aldosterone-Producing Adrenal Adenoma

Phillips

Walther

Pezzullo

et al. 2000

The Journal of Clinical Endocrinology & Metabolism

124

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In primary hyperaldosteronism, discriminating bilateral adrenal hyperplasia (BAH) from an aldosterone-producing adenoma (APA) is important because adrenalectomy, which is usually curative in APA, is seldom effective in BAH. We analyzed the results from our most recent 7-yr series to evaluate the predictive value of preoperative noninvasive tests compared with adrenal vein sampling (AVS). Forty-eight patients with hypertensive hyperaldosteronism underwent bedside testing, computed tomography (CT) imaging, and AVS. Those in whom the results of AVS indicated APA underwent adrenalectomy. Twelve (30%) and 14 (34%) of 41 patients with APA had paradoxical falls with ambulation in plasma aldosterone concentration (PAC) and 18-hydroxycorticosterone (18-OH-B), respectively. Twenty-nine (70%) and 26 (65%) APA patients had a rise in PAC and 18-OH-B, respectively, as did all 8 BAH patients. Significant identifiers of BAH were supine PAC values less than 15 ng/dL (P: = 0.04), an increase greater than 60% (P: = 0.02) in PAC with ambulation, and supine 18-OH-B values less than 60 ng/dL (P: = 0.04). CT imaging alone was not predictive for BAH or APA. In our population, patients with a positive bedside test result (e.g. a fall in PAC and/or 18-OH-B) and a unilateral adrenal nodule on CT (10 of 41 patients) could have proceeded directly to adrenalectomy for APA. However, a positive bedside test result with a negative CT or a negative bedside test result regardless of CT findings required AVS to confirm the diagnosis and site of disease.

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confidence: 99%

Predictive Value of Preoperative Tests in Discriminating Bilateral Adrenal Hyperplasia from an Aldosterone-Producing Adrenal Adenoma

Phillips

Walther

Pezzullo

et al. 2000

The Journal of Clinical Endocrinology & Metabolism

124

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“…Thus, patients with bilateral nodularity or normal-appearing adrenal glands on CT should be referred to for adrenal vein sampling (AVS). [ 9 ]…”

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Anatomical and functional imaging in endocrine hypertension

Chaudhary

Bano

2012

Indian J Endocr Metab

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In endocrine hypertension, hormonal excess results in clinically significant hypertension. The functional imaging (such as radionuclide imaging) complements anatomy-based imaging (such as ultrasound, computed tomography, and magnetic resonance imaging) to facilitate diagnostic localization of a lesion causing endocrine hypertension. The aim of this review article is to familiarize general radiologists, endocrinologists, and clinicians with various anatomical and functional imaging techniques used in patients with endocrine hypertension.

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Primary Mineralocorticoid Excess Disorders and Hypertension

Carey¹,

Padia²

2016

Endocrinology: Adult and Pediatric

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Primary Aldosteronism: Computerized Tomography in Preoperative Evaluation

Cited by 12 publications

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Predictive Value of Preoperative Tests in Discriminating Bilateral Adrenal Hyperplasia from an Aldosterone-Producing Adrenal Adenoma

Predictive Value of Preoperative Tests in Discriminating Bilateral Adrenal Hyperplasia from an Aldosterone-Producing Adrenal Adenoma

Anatomical and functional imaging in endocrine hypertension

Primary Mineralocorticoid Excess Disorders and Hypertension

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