Primary hyperaldosteronism CT scan Findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Adrenal CT scan may be helpful in the diagnosis of primary hyperaldosteronism. Findings on CT scan suggestive of primary hyperaldosteronism are signal intensity near to <10 HU, no contrast enhancement, and non-calcified lesion in adrenal gland.
CT scan
- Adrenal CT scan may be helpful in the diagnosis of primary hyperaldosteronism.
- Adrenal adenomas may display the following features on CT scanning:[1][2]
- Functional adenomas are homogeneous and hypodense.
- The signal intensity may be near to <10 HU.
- No contrast enhancement
- Non-calcified
- A high-resolution CT (HRCT) scan with contrast, has a high sensitivity (78%) and specificity (75%) for detection of adrenal masses (including aldosterone producing adenomas-APAs)
- CT scan is best when used for adrenal adenomas >2 cm but accuracy decreases if the mass is <1 cm.
- A unilateral lesion exceeding 4 cm suggests possible carcinoma
- Moreover, it cannot distinguish between a functional APA and a non-secreting adrenal adenoma (incidentaloma).
- If CT findings are negative, selective adrenal venous sampling for aldosterone or a dexamethasone suppressed iodocholesterol adrenal scan may identify the tumor.
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References
- ↑ Kline GA, Dias VC, So B, Harvey A, Pasieka JL (2014). "Despite limited specificity, computed tomography predicts lateralization and clinical outcome in primary aldosteronism". World J Surg. 38 (11): 2855–62. doi:10.1007/s00268-014-2694-9. PMID 25002246.
- ↑ Dekkers T, Prejbisz A, Kool LJ, Groenewoud HJ, Velema M, Spiering W, Kołodziejczyk-Kruk S, Arntz M, Kądziela J, Langenhuijsen JF, Kerstens MN, van den Meiracker AH, van den Born BJ, Sweep FC, Hermus AR, Januszewicz A, Ligthart-Naber AF, Makai P, van der Wilt GJ, Lenders JW, Deinum J (2016). "Adrenal vein sampling versus CT scan to determine treatment in primary aldosteronism: an outcome-based randomised diagnostic trial". Lancet Diabetes Endocrinol. 4 (9): 739–46. doi:10.1016/S2213-8587(16)30100-0. PMID 27325147.