When is this exam indicated?
It is performed in case of:
- Cushing's syndrome or disease, to demonstrate and localize the adenoma and possible suppression of the extranodular parenchyma; to make the differential diagnosis with bilateral adrenal hyperplasia.
- Crohn's disease, for differential diagnosis between adenoma and bilateral adrenal hyperplasia.
- Virilizing syndromes. The criteria for admission to the examination are: presence of hypercholesterolemia, high levels of ACTH, hyperaldosteronemia depending on the pathology and adrenal lesions suspected by other instrumental investigations.
How is it performed?
The patient drinks a 2% Lugol's solution for 3-4 days before the examination and for the duration of the investigation to protect the thyroid.
In the case of Crohn's disease and virilizing syndromes, the corticoadrenal scintigraphy can be combined with the inhibition test with Desamethazone (4mg/day for 7-10 days).
The examination takes about 20 minutes and images can be repeated daily for 7-10 days.
There are interferences with:
spironolactone: causes increased adrenal take-up even in the presence of suppression with desamethazone;
estrogens: give an earlier bilateral uptake of nor-cholesterol;
corticosteroids: inhibit the absorption.
contraindications to the use of ionizing radiation: e.g. pregnancy