Display Settings:

Format

Send to:

Choose Destination
Surgery. 1996 Dec;120(6):913-9; discussion 919-20.

Primary aldosteronism: adrenal venous sampling.

Author information

  • 1Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905, USA.

Abstract

BACKGROUND:

In primary aldosteronism, high-resolution adrenal computed tomography (CT) increasingly identifies subtle anatomic abnormalities. To interpret the functional significance of adrenal micronodular changes on CT scan, we have reevaluated selective adrenal venous sampling.

METHODS:

Thirty-four patients with primary aldosteronism were selected prospectively for adrenal venous sampling on the basis of CT findings: normal findings or minimal thickening of an adrenal limb (n = 15), unilateral microadenoma (n = 6), bilateral adrenal nodules (n = 9), or atypical unilateral adrenal macroadenoma (n = 4).

RESULTS:

Both adrenal veins were catheterized in 33 of 34 patients. Six (40%) of 15 patients with normal or minimal adrenal limb thickening had a unilateral source of aldosterone. Six patients with apparent unilateral microadenoma had ipsilateral aldosterone-producing adenomas. Four (44%) of nine patients with bilateral adrenal masses had a unilateral source of aldosterone secretion. Three of four patients with unilateral atypical adrenal macroadenomas had ipsilateral aldosterone-producing adenomas.

CONCLUSIONS:

A unilateral source of aldosterone excess may be found in selected patients with adrenal glands that appear normal or show a minimally expanded adrenal limb on CT scan. Findings on adrenal venous sampling are crucial in determining the source of aldosterone excess in patients with bilateral adrenal masses or atypical-appearing macroadenomas.

PMID:
8957473
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Write to the Help Desk