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Four methods; retroperitoneal air insufflation study, adrenal phlebography, adrenal scintiscan and estimation of plasma aldosterone in adrenal or renal veins, were compared to determine the diagnostic value for the location of adrenal adenoma in 27 patients with primary aldosteronism and one with idiopathic aldosteronism. The location of adrenal adenoma could be certainly determined, in 12 of 27 patients with primary aldosteronism by retroperitoneal air insufflation study, in 7 of 22 by adrenal phlebography, in 18 of 23 by estimation of aldosterone in adrenal or renal vein blood, and in 19 of 27 by adrenal scintiscan. From these results, it is concluded that firstly adrenal scintiscan with 131I-cholesterol and then adrenal phlebography and estimation of aldosterone in adrenal and renal vein blood combined with retroperitoneal air insufflation study should be performed for determination of location of adrenal adenoma in primary aldosteronism.

Comparative Study of Diagnosis for Location of Adrenal Adenoma in Patients with Primary Aldosteronism