AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lingam, R. K.
Right arrow Articles by Reznek, R. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lingam, R. K.
Right arrow Articles by Reznek, R. H.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Hotlight (NEW!)
Right arrow
What's Hotlight?

CT of Primary Hyperaldosteronism (Conn's Syndrome): The Value of Measuring the Adrenal Gland

R. K. Lingam1, S. A. Sohaib1, I. Vlahos1, A. G. Rockall1, A. M. Isidori2, J. P. Monson2, A. Grossman2 and R. H. Reznek1,3

1 Department of Diagnostic Imaging, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, United Kingdom.
2 Department of Endocrinology, St. Bartholomew's Hospital, London EC1A 7BE, United Kingdom.
3 Academic Department of Radiology, St. Bartholomew's Hospital, Dominion House, London EC1A 7BE, United Kingdom.



View larger version (12K):

[in a new window]
  		Fig. 1. —Diagram of adrenal gland illustrates width measurements of body (X) and limb (Y).

 


View larger version (8K):

[in a new window]
  		Fig. 2. —Scatterplots show distribution of mean widths of adrenal limbs in patients with aldosterone-producing adenoma and in those with bilateral adrenal hyperplasia.

 


View larger version (9K):

[in a new window]
  		Fig. 3. —Receiver operating characteristic curves for radiologist assessment of bilateral adrenal hyperplasia or aldosterone-producing adenoma (dashed line) and using mean adrenal limb widths (solid line) for positively diagnosing bilateral adrenal hyperplasia.

 


View larger version (28K):

[in a new window]
  		Fig. 4. —Flowchart shows proposed diagnostic algorithm in primary hyperaldosteronism. Number of cases in our study in each of various categories is shown.

 


View larger version (115K):

[in a new window]
  		Fig. 5. —71-year-old man with primary hyperaldosteronism due to bilateral adrenal hyperplasia. Unenhanced CT image shows markedly enlarged adrenal limbs bilaterally (arrows).

 


View larger version (121K):

[in a new window]
  		Fig. 6. —37-year-old woman with primary hyperaldosteronism due to left aldosterone-producing adenoma. Unenhanced CT image shows 4-cm low-density nodule (curved arrow) in left adrenal gland. Limbs (straight arrows) are not enlarged.

 


View larger version (153K):

[in a new window]
  		Fig. 7A. —50-year-old man with left aldosterone-producing adenoma diagnosed on adrenal venous sampling and histology after surgery but incorrectly diagnosed by radiologist as bilateral adrenal hyperplasia. Unenhanced CT image of right adrenal gland shows no obvious adrenal nodule, but its limbs (arrows) appear hyperplastic.

 


View larger version (106K):

[in a new window]
  		Fig. 7B. —50-year-old man with left aldosterone-producing adenoma diagnosed on adrenal venous sampling and histology after surgery but incorrectly diagnosed by radiologist as bilateral adrenal hyperplasia. Unenhanced CT image of left adrenal gland shows its limbs (straight arrow) appear hyperplastic. However, mean limb width of both glands is 4.3 mm and algorithm suggests adrenal venous sampling. In retrospect, slightly nodular appearance of medial limb (curved arrow) could represent missed adenoma.

 


View larger version (155K):

[in a new window]
  		Fig. 8A. —43-year-old woman with histologically confirmed nodular bilateral adrenal hyperplasia that was incorrectly diagnosed as aldosterone-producing adenoma by radiologist. Enhanced CT image shows 2.5-cm nodule (arrow) in left adrenal gland.

 


View larger version (151K):

[in a new window]
  		Fig. 8B. —43-year-old woman with histologically confirmed nodular bilateral adrenal hyperplasia that was incorrectly diagnosed as aldosterone-producing adenoma by radiologist. Enhanced CT image obtained more caudally shows measurably hyperplastic limbs (arrows) bilaterally with mean limb width of 5.2 mm. Right medial limb width is 4.7 mm; right lateral limb width, 5.1 mm; left medial limb width, 6.1 mm; and left lateral limb width, 5.2 mm.

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2003 by the American Roentgen Ray Society.