Role of radiology in the management of primary aldosteronism. Export

@article{citeulike:1643392, abstract = {The diagnosis of primary aldosteronism, the most common form of secondary hypertension, is based on clinical and biochemical features. Although radiology plays no role in the initial diagnosis, it has an important role in differentiating between the two main causes of primary aldosteronism: aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH). This distinction is important because APAs are generally managed surgically and BAH medically. Adrenal venous sampling is considered the standard of reference for determining the cause of primary aldosteronism but is technically demanding, operator dependent, costly, and time consuming, with a low but significant complication rate. Other imaging modalities, including computed tomography, magnetic resonance imaging, and adrenal scintigraphy, have also been used to determine the cause of primary aldosteronism. Cross-sectional imaging has traditionally focused on establishing the diagnosis of an APA, with that of BAH being one of exclusion. A high specificity for detecting an APA is desirable, since it will avert unnecessary surgery in patients with BAH. However, an overreliance on cross-sectional imaging can lead to the incorrect treatment of affected patients, mainly due to the wide variation in the reported diagnostic performance of these modalities. A combination of modalities is usually required to confidently determine the cause of primary aldosteronism. The quest for optimal radiologic management of primary aldosteronism continues just over a half century since this disease entity was first described.}, address = {Department of Radiology, Central Middlesex and Northwick Park Hospitals, North West London Hospitals Trust, Watford Rd, Harrow HA1 3UJ, England.}, author = {Patel, S. M. and Lingam, R. K. and Beaconsfield, T. I. and Tran, T. L. and Brown, B.}, citeulike-article-id = {1643392}, citeulike-linkout-0 = {http://dx.doi.org/10.1148/rg.274065150}, citeulike-linkout-1 = {http://radiographics.rsnajnls.org/cgi/content/abstract/27/4/1145}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/17620472}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=17620472}, doi = {10.1148/rg.274065150}, issn = {1527-1323}, journal = {Radiographics}, keywords = {adrenal, aldosteronism, conns, hyperplasia, primary}, number = {4}, pages = {1145--1157}, posted-at = {2008-11-25 11:05:19}, priority = {2}, title = {Role of radiology in the management of primary aldosteronism.}, url = {http://dx.doi.org/10.1148/rg.274065150}, volume = {27}, year = {2007} }

TY - JOUR ID - citeulike:1643392 L3 - citeulike-article-id:1643392 N2 - The diagnosis of primary aldosteronism, the most common form of secondary hypertension, is based on clinical and biochemical features. Although radiology plays no role in the initial diagnosis, it has an important role in differentiating between the two main causes of primary aldosteronism: aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH). This distinction is important because APAs are generally managed surgically and BAH medically. Adrenal venous sampling is considered the standard of reference for determining the cause of primary aldosteronism but is technically demanding, operator dependent, costly, and time consuming, with a low but significant complication rate. Other imaging modalities, including computed tomography, magnetic resonance imaging, and adrenal scintigraphy, have also been used to determine the cause of primary aldosteronism. Cross-sectional imaging has traditionally focused on establishing the diagnosis of an APA, with that of BAH being one of exclusion. A high specificity for detecting an APA is desirable, since it will avert unnecessary surgery in patients with BAH. However, an overreliance on cross-sectional imaging can lead to the incorrect treatment of affected patients, mainly due to the wide variation in the reported diagnostic performance of these modalities. A combination of modalities is usually required to confidently determine the cause of primary aldosteronism. The quest for optimal radiologic management of primary aldosteronism continues just over a half century since this disease entity was first described. IS - 4 JF - Radiographics SN - 1527-1323 AD - Department of Radiology, Central Middlesex and Northwick Park Hospitals, North West London Hospitals Trust, Watford Rd, Harrow HA1 3UJ, England. EP - 1157 TI - Role of radiology in the management of primary aldosteronism. VL - 27 SP - 1145 KW - adrenal KW - aldosteronism KW - conns KW - hyperplasia KW - primary AU - Patel, SM AU - Lingam, RK AU - Beaconsfield, TI AU - Tran, TL AU - Brown, B PY - 2007///g UR - http://dx.doi.org/10.1148/rg.274065150 ER -