Hoefnagels W H, Claessens R A, Corstens F H, Drayer J I, Kazem I, Kloppenborg P W
Nuklearmedizin. 1981 Apr;20(2):76-81.
Dexamethasone-modified adrenal scintigrams were performed on 13 patients with an aldosterone-producing adenoma and on one patient with an aldosterone-producing carcinoma. Adrenal scintigrams using 131I-19-Iodocholesterol were obtained after short pre-treatment with dexamethasone, while 131I-6 beta-Iodomethyl-19-Nor-Cholesterol scintigrams were performed after long-term pre-treatment with dexamethasone during 9-21 days. Using the former procedure the adrenal scintigrams correctly identified the adenoma in 3 of 8 patients, while with the latter procedure the adrenal scintigrams localized the adenomas in 8 out of 9 patients, including 3 patients in whom the former procedure had failed. The adrenal carcinoma was not visualized with 131I-6 beta-Iodomethyl-19-Nor-Cholesterol. Thus, the sensitivity of 131I-19-Iodocholesterol scintigrams to detect aldosterone-producing adenomas was only 37.5%. Uptake of radioactivity in the normal contralateral adrenal gland accounted for the low detection rate. On the other hand, the 131I-6 beta-Iodomethyl-19-Nor-Cholesterol scintigrams, performed after long-term pre-treatment with dexamethasone, had a sensitivity of 89%. It is suggested that long-term pre-treatment with dexamethasone contributed to the improved sensitivity by a more effective suppression of radioactivity uptake in the normal adrenal gland.
对13例醛固酮分泌性腺瘤患者和1例醛固酮分泌性癌患者进行了地塞米松改良肾上腺闪烁扫描。使用131I-19-碘胆固醇进行肾上腺闪烁扫描是在用地塞米松进行短期预处理后进行的，而使用131I-6β-碘甲基-19-去甲胆固醇闪烁扫描是在用地塞米松进行9至21天的长期预处理后进行的。采用前一种方法，肾上腺闪烁扫描在8例患者中的3例中正确识别出腺瘤，而采用后一种方法，肾上腺闪烁扫描在9例患者中的8例中定位出腺瘤，其中包括3例前一种方法未能识别的患者。131I-6β-碘甲基-19-去甲胆固醇未能显示出肾上腺癌。因此，131I-19-碘胆固醇闪烁扫描检测醛固酮分泌性腺瘤的敏感性仅为37.5%。正常对侧肾上腺的放射性摄取导致了低检测率。另一方面，在用地塞米松进行长期预处理后进行的131I-6β-碘甲基-19-去甲胆固醇闪烁扫描的敏感性为89%。提示地塞米松长期预处理通过更有效地抑制正常肾上腺的放射性摄取而提高了敏感性。
