Determine adrenal suppressibility with prescan administration of corticosteroid to diagnose and localize adrenal adenoma, aldosteronomas, androgen excess, and low-renin hypertension.Aid in the diagnosis of gland tissue destruction caused by infection, infarction, neoplasm, or suppression.Aid in the diagnosis of Cushing’s syndrome and aldosteronism.Patients with a known hypersensitivity to the medium may benefit from premedication with corticosteroids and diphenhydramine the use of nonionic contrast or an alternative noncontrast imaging study, if available, may be considered for patients who have severe asthma or who have experienced moderate to severe reactions to ionic contrast medium. In the case of shellfish, the reaction is to a muscle protein called tropomyosin in the case of iodinated contrast medium, the reaction is to the noniodinated part of the contrast molecule. Although patients are still asked specifically if they have a known allergy to iodine or shellfish, it has been well established that the reaction is not to iodine in fact, an actual iodine allergy would be very problematic because iodine is required for the production of thyroid hormones. high alert Conditions associated with adverse reactions to contrast medium (e.g., asthma, food allergies, or allergy to contrast medium).high alert Patients who are pregnant or suspected of being pregnant, unless the potential benefits of a procedure using radiation far outweigh the risk of radiation exposure to the fetus and mother.Following prescanning treatment with corticosteroids, suppression studies can also be done to differentiate the presence of tumor from hyperplasia of the glands.
Imaging can reveal increased uptake, unilateral or bilateral uptake, or absence of uptake in the detection of pathological processes. The uptake of the radionuclide occurs gradually over time and imaging is performed within 24 to 48 hr of radionuclide injection and continued daily for 3 to 5 days. High concentrations of cholesterol (the precursor in the synthesis of adrenocorticosteroids, including aldosterone) are stored in the adrenal cortex and this allows the radionuclide, which attaches to the cholesterol, to be used in identifying pathology in the secretory function of the adrenal cortex. Adrenal imaging is most useful in differentiation of hyperplasia from adenoma in primary aldosteronism when computed tomography (CT) and magnetic resonance imaging (MRI) findings are equivocal.
ACTH stimulates the adrenal cortex to produce cortisone and secrete aldosterone. The secretory function of the adrenal glands is controlled primarily by the anterior pituitary, which produces adrenocorticotropic hormone (ACTH). This nuclear medicine study evaluates the function of the adrenal glands.
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