Lamki L M, Haynie T P
University of Texas M.D. Anderson Cancer Center, Department of Nuclear Medicine, Houston 77030.
J Surg Oncol. 1990 Mar;43(3):139-47. doi: 10.1002/jso.2930430304.
Adrenal imaging using radiopharmaceuticals is a functional test that can contribute significantly to surgical management and follow-up of patients with either benign or malignant conditions of the adrenal cortex and medulla. Imaging of the cortex is achieved by iodine-131-labeled iodomethyl nor-cholesterol (NP-59), while adrenal medulla imaging can be successfully accomplished by 131I-metaiodobenzylguanidine (MIBG), which localizes in the adrenergic nerve terminal with norepinephrine. Both tests carry high sensitivity and specificity for functional tumors and hyperplasia, and often better than CT scanning. This article reviews the current status and clinical utility of nuclear imaging of the adrenal cortex in congenital hyperplasia, low renin hypertension and aldosteronism, and Cushing's syndrome. Adrenal medulla imaging is reviewed in light of our experience at the University of Texas M.D. Anderson Cancer Center in pheochromocytoma, neuroblastoma, and other neuroectodermal tumors. Investigation of 131I-MIBG therapy of metastatic tumors of neuroectodermal origin potentially offers a means of at least controlling symptoms of hormonal secretion in these patients.
使用放射性药物进行肾上腺成像是一种功能测试，对肾上腺皮质和髓质的良性或恶性疾病患者的手术管理和随访有显著帮助。皮质成像通过碘-131标记的碘甲基去甲胆固醇（NP-59）实现，而肾上腺髓质成像可通过131I-间碘苄胍（MIBG）成功完成，MIBG与去甲肾上腺素一起定位于肾上腺素能神经末梢。这两种测试对功能性肿瘤和增生均具有高敏感性和特异性，且通常优于CT扫描。本文综述了肾上腺皮质核成像在先天性肾上腺增生、低肾素性高血压和醛固酮增多症以及库欣综合征中的现状和临床应用。根据德克萨斯大学MD安德森癌症中心在嗜铬细胞瘤、神经母细胞瘤和其他神经外胚层肿瘤方面的经验，对肾上腺髓质成像进行了综述。对神经外胚层起源的转移性肿瘤进行131I-MIBG治疗的研究可能为至少控制这些患者的激素分泌症状提供一种方法。
