title: Use of gadolinium contrast adrenal venography for the assessment of primary aldosteronism in a patient with iodine allergy.
abstract: Primary aldosteronism is a relatively common cause of secondary hypertension. It is often important to diagnose this disease accurately, since appropriate surgical therapy may result in cure of the disease. Assessment of the laterality of adrenal hyperfunction is possible using adrenal venous sampling of steroid hormones, but this procedure may not be feasible in patients with allergy to iodinated radiocontrast agents. In this paper, we report a patient with primary aldosteronism who was found to have bilateral adrenal tumors on CT. Because preoperative localization of the hyperfunctioning tumor was important, adrenal venous sampling and venography was performed by a highly-experienced radiologist using the MRI contrast agent gadolinium. After reviewing the data, the patient received a right adrenalectomy. This case report demonstrates that it was possible to perform adrenal venography using gadolinium in this patient, however the safety and efficacy should be re-assessed in individual cases.
authors.affiliation: Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sasamura
authors.forename: Subaru
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Sachio
authors.initials: S
authors.lastname: Kuribayashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Ueno
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takase
authors.forename: Matsuhiko
authors.initials: M
authors.lastname: Hayashi
authors.forename: Takao
authors.initials: T
authors.lastname: Saruta
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000311:Adrenal Glands / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D006929:Hyperaldosteronism / Q000000981:diagnostic imaging*; D006967:Hypersensitivity; D007455:Iodine; D008279:Magnetic Resonance Imaging; D010690:Phlebography / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D007455:Iodine; D005682:Gadolinium