Primary hyperaldosteronism (Conn syndrome): MR imaging findings

• Published in: Radiology Vol. 214; no. 2; p. 527
• Main Authors: Sohaib, S A, Peppercorn, P D, Allan, C, Monson, J P, Grossman, A B, Besser, G M, Reznek, R H
• Format: Journal Article
• Language: English
• Published: United States 01.02.2000
• Subjects: Adenoma - diagnosis; Adenoma - secretion; Adolescent; Adrenal Gland Neoplasms - diagnosis; Adrenal Gland Neoplasms - secretion; Adrenal Glands - pathology; Adult; Aged; Aldosterone - secretion; Female; Humans; Hyperaldosteronism - diagnosis; Hyperaldosteronism - pathology; Hyperplasia; Image Processing, Computer-Assisted; Lipids - analysis; Liver - pathology; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity
• DOI: 10.1148/radiology.214.2.r00fe09527
• ISSN: 0033-8419

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). 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. 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. 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.