What is the role of MRI in the workup of primary aldosteronism?

Updated: Mar 24, 2020
  • Author: Gabriel I Uwaifo, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

It is generally accepted that MRI is not superior to contrast-enhanced CT scanning for adrenal visualization. High-resolution CT scans may actually have better adrenal definition. (See the image below.)

Magnetic resonance imaging (MRI) scan in a patient Magnetic resonance imaging (MRI) scan in a patient with Conn syndrome showing a left adrenal adenoma.

If the screening (CT scanning and/or MRI) of a patient with primary aldosteronism is completely normal, a 6- to 12-month treatment trial with aldosterone antagonists is generally recommended, after which the imaging studies should be repeated. Treatment with glucocorticoids may also be considered for glucocorticoid-remediable aldosteronism (GRA), if this condition is suspected.


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