Comparative study of ultrasound, 131I-19-iodocholesterol scintigraphy, and aortography in localising adrenal lesions.
Twenty-seven consecutive patients with endocrinological disease necessitating adrenal surgery underwent blind preoperative investigation with ultrasound, renal aortography, and adrenocortical scintigraphy for an adrenal lesion. Nine patients had pituitary-dependent Cushing's syndrome, five had pituitary-independent Cushing's syndrome, four had an adrenocortical androgenic excess, and nine had a preoperative diagnosis of phaeochromocytoma. The predictive value of preoperative ultrasound was 100% for a positive finding and 79% for a negative result. Preoperative aortography had a predictive value of 83% for a positive finding and 64% for a negative result; and the predictive value of adrenocortical scintigraphy was 100% for a positive finding and 85% for a negative finding. In localising biochemically suspected adrenal lesions ultrasound should be the first choice, since it is rapid, noninvasive, cheap, and reasonably accurate. Adrenocortical scintigraphy has a similar diagnostic value, especially in Cushing's syndrome, but it is time consuming. Nevertheless, it may be preferable for diagnosing small glucocorticoid-secreting adenomas. Aortography should be reserved for cases with inconclusive diagnoses and suspected extra-adrenal phaeochromocytomas.
D000293:Adolescent; D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis; D000307:Adrenal Gland Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000328:Adult; D001027:Aortography; D002784:Cholesterol; D003480:Cushing Syndrome / Q000175:diagnosis; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D007668:Kidney; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000175:diagnosis; D011877:Radionuclide Imaging; D014463:Ultrasonography
D007457:Iodine Radioisotopes; D002784:Cholesterol