Computed tomography in the localization of aldosterone-secreting adrenal adenomas

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Abstract
Computed tomography (CT) has been shown to detect both adrenal glands in 88.5% of upper abdominal examinations and can visualize at least 1 gland in 96.5% of patients. In examinations carried out specifically to visualize the adrenals, the glands were located in 98% of cases. This technique was used in 18 patients with primary aldosteronism to localize aldosterone-secreting adrenal tumors and to distinguish these from non-adenomas (bilateral adrenal hyperplasia). The results were compared with quadric analysis, a statistical technique to predict the likely surgical outcome. In 7 patients the CT results were verified by operation (6 adenomas, 1 adrenal hypertrophy). In 1 further patient a large adenoma (20 mm in diameter) which had not been predicted by CT scanning was found at operation. In the 10 patients who were medically treated, results concordant with quadric analysis were obtained in 8 cases. CT scanning should be the initial investigation for the pre-operative localization of adenomas but further comparative studies are required.