Primary hyperaldosteronism (Conn syndrome): MR imaging findings.
OBJECTIVE
To describe the magnetic resonance (MR) imaging features of the adrenal glands in primary hyperaldosteronism and assess MR imaging in the detection and characterization of aldosterone-producing adenoma (APA).


METHODS
The authors retrospectively reviewed the cases of 20 patients (13 female and seven male patients; age range, 14-67 years; median age, 46 years) with primary hyperaldosteronism who underwent 1.5-T MR imaging between 1995 and 1998. All patients underwent transverse T1- and T2-weighted imaging, and chemical shift imaging was performed in 17 patients. Imaging results were correlated with findings at biochemical testing, venous sampling, or surgery.


RESULTS
Among the 20 patients, 10 (50%) had APA and 10 (50%) bilateral adrenal hyperplasia (BAH). In the detection of APA, MR imaging had a sensitivity of 70%, specificity of 100%, and accuracy of 85%. APAs (mean size, 20 x 16 mm) were iso- or hypointense relative to the liver on T1-weighted images and slightly hyperintense on T2-weighted images. With chemical shift imaging, the signal intensity decreased on the out-of-phase images in six of seven (86%) patients with APA and in eight of nine (89%) patients with BAH.


CONCLUSIONS
MR imaging has a high specificity in the detection of APA. As with nonhyperfunctioning adenoma, APA and BAH show evidence of intracellular lipid at chemical shift imaging.
Sohaib
S A
SA
Department of Diagnostic Imaging, Dominion House, 59 Bartholomew's Close, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK. S.A.Sohaib@mds.qmw.ac.uk
Peppercorn
P D
PD
Allan
C
C
Monson
J P
JP
Grossman
A B
AB
Besser
G M
GM
Reznek
R H
RH
D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000378:metabolism; D000311:Adrenal Glands / Q000473:pathology; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000378:metabolism; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis* / Q000473:pathology; D006965:Hyperplasia; D007091:Image Processing, Computer-Assisted; D008055:Lipids / Q000032:analysis; D008099:Liver / Q000473:pathology; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D008055:Lipids; D000450:Aldosterone