Primary hyperaldosteronism CT scan Findings: Difference between revisions
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==Overview== | ==Overview== | ||
CT scan may | [[Adrenal gland|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== | ==CT scan== | ||
Adrenal adenomas may display the following features on CT scanning: | * [[Adrenal gland|Adrenal]] CT scan may be helpful in the diagnosis of primary hyperaldosteronism. | ||
*Functional adenomas are homogeneous and hypodense. | * [[Adrenal gland|Adrenal]] [[adenomas]] may display the following features on CT scanning:<ref name="pmid250022462">{{cite journal |vauthors=Kline GA, Dias VC, So B, Harvey A, Pasieka JL |title=Despite limited specificity, computed tomography predicts lateralization and clinical outcome in primary aldosteronism |journal=World J Surg |volume=38 |issue=11 |pages=2855–62 |year=2014 |pmid=25002246 |doi=10.1007/s00268-014-2694-9 |url=}}</ref><ref name="pmid273251472">{{cite journal |vauthors=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 |title=Adrenal vein sampling versus CT scan to determine treatment in primary aldosteronism: an outcome-based randomised diagnostic trial |journal=Lancet Diabetes Endocrinol |volume=4 |issue=9 |pages=739–46 |year=2016 |pmid=27325147 |doi=10.1016/S2213-8587(16)30100-0 |url=}}</ref> | ||
*The signal intensity may be near to <10 HU. | ** Functional [[adenomas]] are [[homogeneous]] and hypodense. | ||
*No contrast enhancement | ** The signal intensity may be near to <10 HU. | ||
*Non-calcified | **No contrast enhancement | ||
**[[Calcification|Non-calcified]] | |||
[[ | *A [[high-resolution CT]] (HRCT) scan with contrast, has a high [[Sensitivity (tests)|sensitivity]] (78%) and [[Specificity (tests)|specificity]] (75%) for detection of adrenal masses (including [[aldosterone]] producing adenomas-APAs) | ||
*[[Computed tomography|CT scan]] is best when used for [[Adrenal adenoma|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. | |||
<figure-inline>[[Image:Adrenal-aldosteronoma.JPG|1024x1024px]]</figure-inline> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 18:17, 3 November 2017
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Primary hyperaldosteronism Microchapters |
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Differentiating Primary Hyperaldosteronism from other Diseases |
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Primary hyperaldosteronism CT scan Findings On the Web |
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American Roentgen Ray Society Images of Primary hyperaldosteronism CT scan Findings |
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Risk calculators and risk factors for Primary hyperaldosteronism CT scan Findings |
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.
<figure-inline>
</figure-inline>
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.