Fischer M, Löhmer H
Institut für Nuklearmedizin, Städtischen Kliniken, Kassel.
Urologe A. 1993 Mar;32(2):128-32.
Localization procedures are required in adrenal diseases after biochemical confirmation of hormonal excess. Whereas computed tomography, ultrasound and--in rare cases--also magnetic resonance are needed to image the morphological abnormalities and the anatomy of neighbouring structures, adrenocortical and adrenomedullary scintigraphy is dependent on a functioning adrenal gland. Adrenocortical scintigraphy has the advantage of being able to differentiate between unilateral adenoma and bilateral hyperplasia in patients with primary hyperaldosteronism. It is of minor significance in patients with Cushing's syndrome or hyperandrogenism. In patients with catecholamine-producing tumours scintigraphy with radioiodine-labelled meta-iodobenzylguanidine (MIBG) may detect intra- and extra-adrenal, uni- and bilateral or multilocular, benign and malignant lesions. In patients with malignant but inoperable phaeochromocytoma, therapy with high doses of MIBG may improve clinical symptoms and reduce tumour volume.
在生化检查证实存在激素分泌过多后，肾上腺疾病需要进行定位检查。虽然计算机断层扫描、超声以及在罕见情况下的磁共振成像用于对形态学异常和邻近结构的解剖结构进行成像，但肾上腺皮质和髓质闪烁扫描依赖于功能正常的肾上腺。肾上腺皮质闪烁扫描的优势在于能够区分原发性醛固酮增多症患者的单侧腺瘤和双侧增生。在库欣综合征或雄激素过多症患者中意义不大。对于儿茶酚胺分泌性肿瘤患者，用放射性碘标记的间碘苄胍（MIBG）进行闪烁扫描可检测肾上腺内和肾上腺外、单侧和双侧或多房性、良性和恶性病变。对于无法手术的恶性嗜铬细胞瘤患者，高剂量MIBG治疗可改善临床症状并缩小肿瘤体积。
