[Diagnosis of Conn's adenoma. Comparative study of x-ray computed tomography and scintigraphy using 19-noriodocholesterol].
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Leprat
F
F
Service d'Endocrinologie, Hôpital Haut Lévêque, CHU de Bordeaux, Pessac.
Olivier-Puel
F
F
Laurent
F
F
Barat
J L
JL
Roger
P
P
Gosse
P
P
Tabarin
A
A
D015071:19-Iodocholesterol / Q000031:analogs & derivatives; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D015071:19-Iodocholesterol