COMPARATIVE-STUDY OF SCINTIGRAPHY AND COM PUTED-TOMOGRAPHY FOR RECOGNITION OF SURGICAL CAUSE OF PRIMARY HYPERALDOSTERONISM

OBJECTIVE: In order to differentiate an aldosterone producing adenoma (APA) and a bilateral adrenal hyperplasia (BAH) in case of primary hyp eraldosteronism, an adrenal CT-scan is usually used as first line expl oration. The contribution of adrenal 19-noriodocholesterol (NP59) -sci ntigraphy is controversial. PATIENTS AND METHODS: We describe 17 cases of primary hyperaldosteronism referred to surgery for suspected APA. The value of abdominal CT-ran 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 sh owed persistence of the disease. The pathologic findings were concorda nt with CT-scan in 76% (13/17) and with scintigraphy in 88% (15/17). S imilar sensitivity was found for CT-scan and scintigraphy (86% and 88% ) with 2 false negative results with both techniques. False positive r esults were observed only with CT-ran (2 cases) suggesting that scinti has a better specificity. No case was misdiagnosed by both techniques. CONCLUSION: These results suggest that NP59-scintigraphy is complemen tary to adrenal CT-scan for the recognition of APA and is particularly useful in case of a unilateral hyperplastic macro nodule mimicking an APA.