RADIONUCLIDE ADRENAL IMAGING IN HYPERTENSION

这项拟议工作的目标有三个方面：1。来证实 我们目前已完成的可行性研究， 患者 这项研究表明，地塞米松抑制肾上腺皮质激素， 放射性碘标记胆固醇扫描显示4个解剖功能 低肾素原发性高血压患者的影像学表现：1.摄取 仅在一侧肾上腺皮质腺瘤中发现一个肾上腺中的I-131。 2. 在大结节增生中发现了早期和晚期的对称性摄取， 肾上腺皮质3.示踪剂后4天或更长时间对称摄取 在微小结节增生中发现了给药。 4.两种都没有摄取 当肾上腺皮质正常时，发现肾上腺早期或晚期。 血液 当使用安体舒通时，压力福尔斯降至正常 肾上腺皮质是异常的，如通过磁共振扫描所识别的，但不响应 当肾上腺皮质正常时，对螺内酯有显著影响。 2.到 放射性标记肾上腺酶抑制剂的合成、开发和评价 腺体将减少成像所需的时间和辐射剂量， 与目前使用的放射性碘化胆固醇相比。 3.为了合成， 开发和评估解剖功能成像能力， 放射性标记的神经元阻断剂和可逆的酶抑制剂， 肾上腺髓质 世界上最成功的 这些放射性标记的显像剂将首先在患者中进行分析， 肾上腺髓质疾病的风险，那么在正常和高 高血压

The objectives of this proposed work are three-fold: 1. To corroborate in a larger prospective study our presently completed feasibility study in 45 patients. This study illustrates that dexamethasone suppression adrenal scintiscanning with radioiodinated cholesterol reveals 4 anatomical-functional imaging patterns in patients with low renin essential hypertension: 1. Uptake of I-131 in one adrenal only is found in an adenoma of one adrenal cortex. 2. Symmetrical uptake early and late is found in macronodular hyperplasia of the adrenal cortex. 3. Symmetrical uptake four days or more after tracer administration is found in micronodular hyperplasia. 4. No uptake in either adrenal early or late is found when the adrenal cortices are normal. Blood pressure falls to normal during the administration of spironolactone when the adrenal cortex is abnormal as recognized by scintiscanning but does not respond significantly to spironolactone when the adrenal cortex is normal. 2. To synthesize, develop and evaluate radiolabeled inhibitors of enzymes in adrenal glands would decrease the time required for imaging and the radiation dose in comparison to the currently used radioiodinated cholesterols. 3. To synthesize, develop and evaluate the anatomical-functional imaging capabilities of radiolabeled neuronal blocking agents, and reversible inhibitors of enzymes in the adrenal medulla. The diagnostic capabilities of the most successful of these radiolabeled imaging agents will be analyzed first in patients most at risk for disease of the adrenal medulla, then in patients with normal and high renin hypertension.