Can an enhanced thin-slice computed tomography delineate the right adrenal vein and improve the success rate?
To evaluate the usefulness of enhanced thin-slice computed tomography (TSCT) for delineating the right adrenal vein (RAV) anatomy before adrenal vein sampling (AVS).
Materials and methods
A total of 151 consecutive AVSs with CT during angiography (interventional CT) were included. Of them, TSCT was performed before AVS for 72 patients. Successful RAV cannulation was confirmed using cortisol measurement. The RAV on TSCT was classified as certain, probable, or unidentified, and cases with certain or probable RAV identification were classified as useful. In the cases where AVS was successful, the anatomical features of the presumed RAV from the useful TSCT, including the position along the inferior vena cava, vertebral level, and distance from the upper pole of the right kidney, were compared with the RAV features identified on interventional CT. Estimated successful cannulation rates before interventional CT were compared between patients with and without useful TSCT.
In total, 66 TSCTs were classified as useful. The anatomical features identified on TSCT were significantly correlated with those on interventional CT. The estimated successful cannulation rates for cases with and without useful TSCT were 92.4 and 82.4 %, respectively.
TSCT clearly shows the anatomical features of the RAV, facilitating accurate sampling and increasing the success rate.
KeywordsPrimary aldosteronism Adrenal venous sampling Interventional CT Thin-slice enhanced computed tomography Anatomical variations
We wish to thank all of the technicians at the Department of Radiology at our institute who performed the TSCT, angiography, and angio-CT scans. This work was supported by JSPS KAKENHI Grant No. 25861130. The guarantor of this study was Satoru Murata. The approval of the local ethics committee was not required because this was a retrospective study. Our previous publication  on angio-CT during AVS used 140 patients that overlapped with the current study.
Compliance with ethical standards
Conflict of interest
There was no conflict of interests in all authors.
Written informed consent was obtained from all patients, and the study was approved by the local ethics committee.
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- 7.Young WF Jr, Klee GG. Primary aldosteronism. Diagnostic evaluation. Endocrinol Metab Clin N Am. 1988;17:367–95.Google Scholar
- 14.Nishikawa T, Omura M, Satoh F, Shibata H, Takahashi K, Tamura N, et al. Task Force Committee on Primary Aldosteronism, The Japan Endocrine Society. Guidelines for the diagnosis and treatment of primary aldosteronism–the Japan Endocrine Society 2009. Endocr J. 2011;58:711–21.CrossRefPubMedGoogle Scholar