Role of radiologists in the diagnosis and management of adrenal disorders
This study aimed to focus on the role of radiologists in the diagnosis and management of adrenal lesions, particularly primary aldosteronism (PA) and secondary hypertension. As hypertension affects more than one-third of the population in Japan, identifying secondary causes such as PA and adrenal le...
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| Format: | Article |
| Language: | English |
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The Japan Endocrine Society
2025-02-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/72/2/72_EJ24-0156/_html/-char/en |
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| author | Sota Oguro Hiromitsu Tannai Hideki Ota Kazumasa Seiji Hiroki Kamada Yoshitaka Toyama Kei Omata Yuta Tezuka Yoshikiyo Ono Fumitoshi Satoh Sadayoshi Ito Tetsuhiro Tanaka Hideki Katagiri Kei Takase |
| author_facet | Sota Oguro Hiromitsu Tannai Hideki Ota Kazumasa Seiji Hiroki Kamada Yoshitaka Toyama Kei Omata Yuta Tezuka Yoshikiyo Ono Fumitoshi Satoh Sadayoshi Ito Tetsuhiro Tanaka Hideki Katagiri Kei Takase |
| author_sort | Sota Oguro |
| collection | DOAJ |
| description | This study aimed to focus on the role of radiologists in the diagnosis and management of adrenal lesions, particularly primary aldosteronism (PA) and secondary hypertension. As hypertension affects more than one-third of the population in Japan, identifying secondary causes such as PA and adrenal lesions is crucial. Establishing a radiological differential diagnosis of adrenal lesions using advanced imaging techniques, such as computed tomography and magnetic resonance imaging, is crucial. Knowledge of the imaging findings of various benign and malignant adrenal lesions, such as adrenocortical adenomas, cortisol-producing lesions, pheochromocytomas, adrenocortical carcinoma, malignant lymphoma, and metastatic tumors, is necessary. Adrenal venous sampling (AVS) plays a crucial role in accurately localizing aldosterone hypersecretion in PA, especially when imaging fails to provide a clear diagnosis. This paper details the technical aspects of AVS, emphasizing catheterization techniques, anatomical considerations, and the importance of preprocedural imaging for successful sampling. Furthermore, we explore segmental adrenal venous sampling (SAVS), a more refined technique that samples specific adrenal tributary veins, offering enhanced diagnostic accuracy, particularly for microadenomas or challenging cases that may be missed with conventional AVS. The methodology for performing SAVS, along with the interpretation criteria for successful sampling and lateralization, is also outlined. Furthermore, radiologists have initiated treatments for unilateral PA, such as radiofrequency ablation, and play an integral role in the management of adrenal lesions. Collaborative approaches across clinical departments are required to enhance patient management in medical care involving the adrenal gland. |
| format | Article |
| id | doaj-art-3bf5235947fd4a8fa55c8e36f666e9ef |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-3bf5235947fd4a8fa55c8e36f666e9ef2025-02-03T01:08:32ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402025-02-0172213114810.1507/endocrj.EJ24-0156endocrjRole of radiologists in the diagnosis and management of adrenal disordersSota Oguro0Hiromitsu Tannai1Hideki Ota2Kazumasa Seiji3Hiroki Kamada4Yoshitaka Toyama5Kei Omata6Yuta Tezuka7Yoshikiyo Ono8Fumitoshi Satoh9Sadayoshi Ito10Tetsuhiro Tanaka11Hideki Katagiri12Kei Takase13Department of Diagnostic Radiology, Tohoku University Hospital, Miyagi 980-8574, JapanDepartment of Diagnostic Radiology, Tohoku University Hospital, Miyagi 980-8574, JapanDepartment of Diagnostic Radiology, Tohoku University Hospital, Miyagi 980-8574, JapanDepartment of Diagnostic Radiology, South Miyagi Medical Center, Miyagi 989-1253, JapanDepartment of Diagnostic Radiology, Tohoku University Hospital, Miyagi 980-8574, JapanDepartment of Diagnostic Radiology, Tohoku University Hospital, Miyagi 980-8574, JapanDepartment of Diabetes, Metabolism and Endocrinology, Tohoku University Hospital, Miyagi 980-8574, JapanDepartment of Diabetes, Metabolism and Endocrinology, Tohoku University Hospital, Miyagi 980-8574, JapanDepartment of Diabetes, Metabolism and Endocrinology, Tohoku University Hospital, Miyagi 980-8574, JapanDivision of Nephrology, Rheumatology and Endocrinology, Tohoku University, Miyagi 980-8574, JapanDepartment of Nephrology, Katta General Hospital, Miyagi 989-0231, JapanDivision of Nephrology, Rheumatology and Endocrinology, Tohoku University, Miyagi 980-8574, JapanDepartment of Diabetes, Metabolism and Endocrinology, Tohoku University Hospital, Miyagi 980-8574, JapanDepartment of Diagnostic Radiology, Tohoku University Hospital, Miyagi 980-8574, JapanThis study aimed to focus on the role of radiologists in the diagnosis and management of adrenal lesions, particularly primary aldosteronism (PA) and secondary hypertension. As hypertension affects more than one-third of the population in Japan, identifying secondary causes such as PA and adrenal lesions is crucial. Establishing a radiological differential diagnosis of adrenal lesions using advanced imaging techniques, such as computed tomography and magnetic resonance imaging, is crucial. Knowledge of the imaging findings of various benign and malignant adrenal lesions, such as adrenocortical adenomas, cortisol-producing lesions, pheochromocytomas, adrenocortical carcinoma, malignant lymphoma, and metastatic tumors, is necessary. Adrenal venous sampling (AVS) plays a crucial role in accurately localizing aldosterone hypersecretion in PA, especially when imaging fails to provide a clear diagnosis. This paper details the technical aspects of AVS, emphasizing catheterization techniques, anatomical considerations, and the importance of preprocedural imaging for successful sampling. Furthermore, we explore segmental adrenal venous sampling (SAVS), a more refined technique that samples specific adrenal tributary veins, offering enhanced diagnostic accuracy, particularly for microadenomas or challenging cases that may be missed with conventional AVS. The methodology for performing SAVS, along with the interpretation criteria for successful sampling and lateralization, is also outlined. Furthermore, radiologists have initiated treatments for unilateral PA, such as radiofrequency ablation, and play an integral role in the management of adrenal lesions. Collaborative approaches across clinical departments are required to enhance patient management in medical care involving the adrenal gland.https://www.jstage.jst.go.jp/article/endocrj/72/2/72_EJ24-0156/_html/-char/enprimary aldosteronismsegmental adrenal venous samplingadrenal imaging techniquessecondary hypertension managementaldosterone producing adenoma |
| spellingShingle | Sota Oguro Hiromitsu Tannai Hideki Ota Kazumasa Seiji Hiroki Kamada Yoshitaka Toyama Kei Omata Yuta Tezuka Yoshikiyo Ono Fumitoshi Satoh Sadayoshi Ito Tetsuhiro Tanaka Hideki Katagiri Kei Takase Role of radiologists in the diagnosis and management of adrenal disorders Endocrine Journal primary aldosteronism segmental adrenal venous sampling adrenal imaging techniques secondary hypertension management aldosterone producing adenoma |
| title | Role of radiologists in the diagnosis and management of adrenal disorders |
| title_full | Role of radiologists in the diagnosis and management of adrenal disorders |
| title_fullStr | Role of radiologists in the diagnosis and management of adrenal disorders |
| title_full_unstemmed | Role of radiologists in the diagnosis and management of adrenal disorders |
| title_short | Role of radiologists in the diagnosis and management of adrenal disorders |
| title_sort | role of radiologists in the diagnosis and management of adrenal disorders |
| topic | primary aldosteronism segmental adrenal venous sampling adrenal imaging techniques secondary hypertension management aldosterone producing adenoma |
| url | https://www.jstage.jst.go.jp/article/endocrj/72/2/72_EJ24-0156/_html/-char/en |
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