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Langenbeck's Archives of Surgery

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01-09-2007 | Original Article

Noninvasive adrenal imaging in hyperaldosteronism: is it accurate for correctly identifying patients who should be selected for surgery?

Authors: Celestino Pio Lombardi, Marco Raffaelli, Carmela De Crea, Vittoria Rufini, Giorgio Treglia, Rocco Bellantone

Published in: Langenbeck's Archives of Surgery | Issue 5/2007

Abstract

Background and aims

The most common causes of hyperaldosteronism (HA) are bilateral idiopathic hyperaldosteronism (IHA), aldosterone-producing adenoma (APA), and unilateral primary adrenal hyperplasia (PAH). We evaluated if non-invasive preoperative imaging studies are able to reliably differentiate these causes of hyperaldosteronism.

Methods

The medical records of 50 consecutive patients with HA were reviewed. Follow up was obtained by outpatient consultation or phone contact.

Results

Thirty-five patients (70%) underwent successful adrenalectomy for APA, basing on the computed tomography (CT) scan results only. All these patients were biochemically cured. The remaining 15 patients underwent dexamethasone suppression adrenal cortical scintiscan (ACS) because of equivocal or inconclusive CT scan. In 11 of these patients, ACS showed a bilateral uptake, suggesting IHA. They were followed-up. In the remaining four patients, ACS showed a unilateral uptake. These patients underwent adrenalectomy. Final histology showed APA in three patients and PAH in one. They were biochemically cured. Sensitivity of combined non-invasive imaging procedures (CT and ACS) in detecting histologically proven and biochemically cured APA and PAH was 100%.

Conclusion

Non-invasive adrenal imaging studies are accurate in distinguishing between IHA and APA/PAH. Invasive diagnostic tests (adrenal venous sampling) should be indicated only when they do not conclusively localize hypersecretion.

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Title: Noninvasive adrenal imaging in hyperaldosteronism: is it accurate for correctly identifying patients who should be selected for surgery?
Authors: Celestino Pio Lombardi
Marco Raffaelli
Carmela De Crea
Vittoria Rufini
Giorgio Treglia
Rocco Bellantone
Publication date: 01-09-2007
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 5/2007
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-006-0137-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Noninvasive adrenal imaging in hyperaldosteronism: is it accurate for correctly identifying patients who should be selected for surgery?

Abstract

Background and aims

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and aims

Methods

Results

Conclusion

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