副腎腫瘍局在性診断に関する検討 : 副腎静脈撮影

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A clinical analysis of selective adrenal venography on 17 cases of primary aldosteronism, 5 cases of Cushing's syndrome, 3 cases of pheochromocytoma, 1 case of adreno-cortical carcinoma, 1 case of adreno-genital syndrome and 1 case of unilateral adrenal hematoma revealed the following findings. As for complications, one patient having aldosteronoma exhibited transient mild tetany-like seizure during the examination and two patients experienced a moderate pain after rupture of their adrenal veins. The pheochromocytoma cases did not show any blood pressure change during the procedure. Adrenal venography can be performed without grave untoward effects if proper cares are paid to the procedure. 16 cases out of 17 aldosteronomas were diagnosed accurately by the venography and their chief findings were circular vein around oval avascular or blushed area, shift or obstruction of the central vein, and radiating veins. In contrast to the similar venographic findings of Cushin's syndrome producing adenoma to that of aldosteronoma, 3 cases of nodular hyperplasia showed mesh-like patterns. From the above findings, venographic patterns of adrenocortical tumors were divided into "egg in egg-cup", "basket", "balloon catheter-tip","spoke of a wheel", and "mesh". Selective adrenal venography could viscualize the tumor size and the venous vascularity in addition to the laterality of the masses in 3 cases of pheochromocytoma which were not demonstrated well by the other locality diagnosing techniques. The adreno-cortical carcinoma case showed "cut off" of the large central vein associated with marked weaving vein. In conclusion, adrenal venography in combination with selective venous sampling method can furnish us with valuable informations regarding adrenal mass lesions if performed under meticulous care and skill.
社団法人日本泌尿器科学会の論文

副腎腫瘍局在性診断に関する検討 : 副腎静脈撮影

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