Radiologic Notes in Cardiology

نویسنده

  • Harold A. Mitty
چکیده

PATIENTS with hypertension may exhibit clinical signs and biochemical abnorm,alities which point to an adrenal lesion as the underlying cause. The presence of episodic hypertension, Cushing's syndrome, elevated urine vanillylmandelic acid and metanephrine, or persistent hypokalemia is an important finding that suggests an adrenal lesion. Ultimately, the actual demonstration of the lesion, localization of the proper side, or, in the case of the pheochromocytoma, proof of the adrenal or extraadrenal location of a mass is an important consideratioln prior to surgical intervention. This can be relatively easily and accurately accomplished by adrenal venography.'e 2 Prior to the development of selective angiographic technics, roentgenologic evaluation of the adrenal gland was a relatively gross procedure and usually only large lesions could be identified. Unless the lesion was of such a size that it displaced the kidney, urography was of little value. Presacral gas studies were somewhat more sensitive if adequate amounts of gas dissected around the gland. Even when adequate gas distribution was obtained, one only visualized the contour of the gland so that small or completely intraparenchymal lesions were missed by this technic. Angiographic evaluation of the adrenal gland can be performed from the arterial or venous approach. Aortography is usually inadequate for the demonstration of small lesions because the overlying mesenteric,

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تاریخ انتشار 2005