Leprat F, Olivier-Puel F, Laurent F, Barat J L, Roger P, Gosse P, Tabarin A
Service d'Endocrinologie, Hôpital Haut Lévêque, CHU de Bordeaux, Pessac.
Presse Med. 1997 Oct 18;26(31):1469-73.
In order to differentiate an aldosterone producing adenoma (APA) and a bilateral adrenal hyperplasia (BAH) in case of primary hyperaldosteronism, an adrenal CT-scan is usually used as first line exploration. The contribution of adrenal 19-noriodocholesterol (NP59)-scintigraphy is controversial.
We describe 17 cases of primary hyperaldosteronism referred to surgery for suspected APA. The value of abdominal CT-scan and of adrenal scintigraphy was studied.
After unilateral adrenalectomy, 15 cases with confirmed APA were cured and 2 cases with an unilateral hyperplastic macro nodule showed persistence of the disease. The pathologic findings were concordant with CT-scan in 76% (13/17) and with scintigraphy in 88% (15/17). Similar sensitivity was found for CT-scan and scintigraphy (86% and 88%) with 2 false negative results with both techniques. False positive results were observed only with CT-scan (2 cases) suggesting that scintigraphy has a better specificity. No case was misdiagnosed by both techniques.
These results suggest that NP59-scintigraphy is complementary to adrenal CT-scan for the recognition of APA and is particularly useful in case of a unilateral hyperplastic macro nodule mimicking an APA.
