Cargando…
Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism
CONTEXT: In patients with primary aldosteronism (PA), it remains unclear whether aldosterone-producing adenomas are likely to develop in the left or right adrenal gland. OBJECTIVE: To investigate left-right differences of PA laterality diagnoses via CT imaging and adrenal vein sampling (AVS). DESIGN...
Autores principales: | , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Endocrine Society
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608550/ https://www.ncbi.nlm.nih.gov/pubmed/31286105 http://dx.doi.org/10.1210/js.2019-00131 |
_version_ | 1783432187900592128 |
---|---|
author | Wada, Norio Shibayama, Yui Yoneda, Takashi Katabami, Takuyuki Kurihara, Isao Tsuiki, Mika Ichijo, Takamasa Ogawa, Yoshihiro Kawashima, Junji Sone, Masakatsu Yoshimoto, Takanobu Matsuda, Yuichi Fujita, Megumi Kobayashi, Hiroki Tamura, Kouichi Kamemura, Kohei Otsuki, Michio Okamura, Shintaro Naruse, Mitsuhide |
author_facet | Wada, Norio Shibayama, Yui Yoneda, Takashi Katabami, Takuyuki Kurihara, Isao Tsuiki, Mika Ichijo, Takamasa Ogawa, Yoshihiro Kawashima, Junji Sone, Masakatsu Yoshimoto, Takanobu Matsuda, Yuichi Fujita, Megumi Kobayashi, Hiroki Tamura, Kouichi Kamemura, Kohei Otsuki, Michio Okamura, Shintaro Naruse, Mitsuhide |
author_sort | Wada, Norio |
collection | PubMed |
description | CONTEXT: In patients with primary aldosteronism (PA), it remains unclear whether aldosterone-producing adenomas are likely to develop in the left or right adrenal gland. OBJECTIVE: To investigate left-right differences of PA laterality diagnoses via CT imaging and adrenal vein sampling (AVS). DESIGN: Retrospective, observational study. PATIENTS: From the Japan Primary Aldosteronism Study, 1493 patients with PA were enrolled who underwent CT and ACTH-stimulated AVS. MEASUREMENTS: Left or right adrenal nodular lesion distribution and laterality observed on CT scans and from AVS were noted. RESULTS: Both on CT scans and AVS, unilateral results were observed more frequently on the left side than on the right side (25.1% vs 15.4% and 17.3% vs 13.5%, respectively; P < 0.01for both diagnostic techniques). There was no significant difference in the concordance rate for CT and AVS between patients with left and right unilateral nodular lesions observed on CT scans (44.1% and 50.9%, respectively; P = 0.15). In patients with nodules <20 mm, the concordance rate was significantly greater on the right side than the left side (45.8% vs 56.4%; P = 0.03). In patients with bilateral results of AVS, unilateral nodular lesions were detected more frequently on the left side than the right side (17.8% vs 9.4%; P < 0.01). CONCLUSION: These results suggest aldosterone-producing adenomas and nonfunctioning tumors are more likely to develop on the left side in patients with PA and that misdiagnosis of CT-based lateralization may occur more frequently on the left side. |
format | Online Article Text |
id | pubmed-6608550 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Endocrine Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-66085502019-07-08 Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism Wada, Norio Shibayama, Yui Yoneda, Takashi Katabami, Takuyuki Kurihara, Isao Tsuiki, Mika Ichijo, Takamasa Ogawa, Yoshihiro Kawashima, Junji Sone, Masakatsu Yoshimoto, Takanobu Matsuda, Yuichi Fujita, Megumi Kobayashi, Hiroki Tamura, Kouichi Kamemura, Kohei Otsuki, Michio Okamura, Shintaro Naruse, Mitsuhide J Endocr Soc Clinical Research Articles CONTEXT: In patients with primary aldosteronism (PA), it remains unclear whether aldosterone-producing adenomas are likely to develop in the left or right adrenal gland. OBJECTIVE: To investigate left-right differences of PA laterality diagnoses via CT imaging and adrenal vein sampling (AVS). DESIGN: Retrospective, observational study. PATIENTS: From the Japan Primary Aldosteronism Study, 1493 patients with PA were enrolled who underwent CT and ACTH-stimulated AVS. MEASUREMENTS: Left or right adrenal nodular lesion distribution and laterality observed on CT scans and from AVS were noted. RESULTS: Both on CT scans and AVS, unilateral results were observed more frequently on the left side than on the right side (25.1% vs 15.4% and 17.3% vs 13.5%, respectively; P < 0.01for both diagnostic techniques). There was no significant difference in the concordance rate for CT and AVS between patients with left and right unilateral nodular lesions observed on CT scans (44.1% and 50.9%, respectively; P = 0.15). In patients with nodules <20 mm, the concordance rate was significantly greater on the right side than the left side (45.8% vs 56.4%; P = 0.03). In patients with bilateral results of AVS, unilateral nodular lesions were detected more frequently on the left side than the right side (17.8% vs 9.4%; P < 0.01). CONCLUSION: These results suggest aldosterone-producing adenomas and nonfunctioning tumors are more likely to develop on the left side in patients with PA and that misdiagnosis of CT-based lateralization may occur more frequently on the left side. Endocrine Society 2019-05-16 /pmc/articles/PMC6608550/ /pubmed/31286105 http://dx.doi.org/10.1210/js.2019-00131 Text en Copyright © 2019 Endocrine Society https://creativecommons.org/licenses/by-nc-nd/4.0/ This article has been published under the terms of the Creative Commons Attribution Non-Commercial, No-Derivatives License (CC BY-NC-ND; https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Research Articles Wada, Norio Shibayama, Yui Yoneda, Takashi Katabami, Takuyuki Kurihara, Isao Tsuiki, Mika Ichijo, Takamasa Ogawa, Yoshihiro Kawashima, Junji Sone, Masakatsu Yoshimoto, Takanobu Matsuda, Yuichi Fujita, Megumi Kobayashi, Hiroki Tamura, Kouichi Kamemura, Kohei Otsuki, Michio Okamura, Shintaro Naruse, Mitsuhide Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism |
title | Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism |
title_full | Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism |
title_fullStr | Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism |
title_full_unstemmed | Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism |
title_short | Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism |
title_sort | lateralizing asymmetry of adrenal imaging and adrenal vein sampling in patients with primary aldosteronism |
topic | Clinical Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608550/ https://www.ncbi.nlm.nih.gov/pubmed/31286105 http://dx.doi.org/10.1210/js.2019-00131 |
work_keys_str_mv | AT wadanorio lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT shibayamayui lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT yonedatakashi lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT katabamitakuyuki lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT kuriharaisao lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT tsuikimika lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT ichijotakamasa lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT ogawayoshihiro lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT kawashimajunji lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT sonemasakatsu lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT yoshimototakanobu lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT matsudayuichi lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT fujitamegumi lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT kobayashihiroki lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT tamurakouichi lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT kamemurakohei lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT otsukimichio lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT okamurashintaro lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT narusemitsuhide lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism AT lateralizingasymmetryofadrenalimagingandadrenalveinsamplinginpatientswithprimaryaldosteronism |