Gianchandani R Y, Quin G A, Grekin R J, Gross M D, Sisson J C, Thompson N W, Shapiro B
Department of Internal Medicine and Surgery, University of Michigan Medical Center, Ann Arbor 48109-0028, USA.
J Nucl Med. 1996 May;37(5):852-4.
Primary aldosteronism is a potentially curable cause of hypertension, especially when caused by an adrenal adenoma. Aldosteronomas because of their small size often elude techniques to locate them. This case illustrates the advantages, disadvantages and complications of noninvasive techniques used for their diagnosis. A patient with hypertension and hypokalemia underwent an adrenal venous effluent sampling for measurement of aldosterone concentrations. This procedure was complicated by an injury to the right adrenal gland. Subsequently, it was difficult to control the patient's hypertension and hypokalemia with medical therapy alone. A re-assessment years after his initial diagnosis included a CT scan, which now visualized a left adrenal tumor. The functional status of this tumor and lack of function of the previously injured right adrenal gland were demonstrated by NP-59 scintigraphy. This information modified the surgical intervention (adenectomy rather than total adrenalectomy) and the residual left sided adrenal tissue prevented adrenocortical insufficiency. A year later the patient remains euadrenal.
原发性醛固酮增多症是高血压一个潜在可治愈的病因，尤其是由肾上腺腺瘤引起时。醛固酮瘤因其体积小常常难以用定位技术找到。本病例说明了用于其诊断的非侵入性技术的优点、缺点和并发症。一名高血压和低钾血症患者接受了肾上腺静脉血样采集以测量醛固酮浓度。该操作因右肾上腺损伤而变得复杂。随后，仅通过药物治疗难以控制患者的高血压和低钾血症。初次诊断数年之后的重新评估包括一次CT扫描，此次扫描发现了一个左侧肾上腺肿瘤。NP - 59闪烁扫描显示了该肿瘤的功能状态以及先前受损的右侧肾上腺无功能。这些信息改变了手术干预方式（腺瘤切除术而非肾上腺全切术），并且残留的左侧肾上腺组织预防了肾上腺皮质功能不全。一年后该患者肾上腺功能正常。
