背景：碘-131-NP-59腎上腺造影是一項非侵襲性腎上腺影像檢查，它能提供腎上腺皮質功能異常的定位及特性。我們報告本院十二年來應用碘-131-NP－59腎上腺造影於ACTH-非依賴性庫欣氏症候群的經驗。
方法：我們回顧本院自1988年7月至2000年8月屬於ACTH-非依賴性庫欣氏症候群而進行碘-131-NP，59造影的患者。這些病人在核醫檢查及腹部電腦斷層攝影之後都接受了腎上腺切除手術並有病理證實。
結果：在碘-131-NP-59造影方面。腎上腺腺瘤有90%(18/20)的病人被正確地診斷出來。腎上腺腺癌的三個病人中，典型的兩側不顯影出現於一個病人，而另外兩個病人則在腺癌的部位有顯影。電腦斷層攝影在所有腺瘤及腺癌的病人身上都掃描出不正常的腎上腺，但在其中一個腺癌的病人身上顯現出兩側腎上腺增生。在腎上腺皮質結節狀增生的病人中，碘-131-NP-59腎上腺造影和電腦斷層攝影在兩側小結節狀增生不良的病人身上皆無發現，而在兩側大結節狀增生的病人身上則都成功地偵測到兩側的病灶。
結論：腎上腺皮質造影的判讀不止依賴生化檢驗的結果，也會被病人所服用的藥物以及是否有高血脂所影響。單側顯影的病灶並非一定就是良性疾病。

Background: Iodine-131-6-β-iodomethyl-19-norcholes-terol (131I-NP-59) imaging is a noninvasive adrenal imaging study that enables localization and characterization of endocrine dysfunction in the adrenal cortex. Herein, we report on our 12-year experience with 131I-NP-59 imaging in the localization of ACTH-independent Cushing's syndrome.
Methods: We reviewed the records of 25 ACTH-inde-pendent Cushing's syndrome patients who had under-gone adrenal scintigraphy in our hospital between January 1988 and August 2000. All patients underwent 131I-NP-59 imaging and CT scanning before adrenalec-tomy and had pathologic examinations.
Results: 131I-NP-59 imaging correctly identified adreno-cortical adenomas in 90% (18/20) of the cases. In adrenocortical carcinoma, the classic scintigraphic pattern of bilateral nonvisualization was observed in 1 of 3 patients, with visualization on the side of the tumor in 2 patients. CT scanning correctly depicted the adrenal lesions in all cases of adenoma and carcinoma except for one case of carcinoma in which bilateral adrenal hyperplasia was demonstrated. In cortical nodular hyperplasia, both 131I-NP-59 imaging and CT scanning showed negative results in bilateral micronodular dysplasia and correctly identified the bilateral nature of bilateral ACTH-independent macronodular hyperplasia.
Conclusions: The interpretation of adrenal scintigraphy is not only directly dependent upon the results of bio-chemical studies, but it also is affected by intradiagnostic medications and hyperlipidemia. Unilateral visualization of an adrenal tumor on 131I-NP-59 imaging cannot be uniformly interpreted to represent benign disease.