Figure 4
From: Aldosterone-producing adenoma and other surgically correctable forms of primary aldosteronism
Computed tomography of the adrenals in three patients with primary aldosteronism. Note the moderate hypertrophy of both adrenal glands in A, the presence of a left hypodense nodule (arrow) in B with a thin right adrenal gland, and the presence of bilateral nodules (arrows) in C. All three aspects may coexist with uni- or bilateral aldosterone hypersecretion, which must be confirmed using adrenal vein sampling. In the patient with the computed tomography shown in C, the aldosterone to cortisol ratio was 1.6 in the inferior vena cava, 0.24 in the left adrenal vein and 42 in the right adrenal vein, indicating the presence of a right aldosterone hypersecretion associated with non-secreting left adenoma.