Japanese Journal of Radiology

, Volume 34, Issue 9, pp 611–619 | Cite as

Can an enhanced thin-slice computed tomography delineate the right adrenal vein and improve the success rate?

  • Shiro OnozawaEmail author
  • Satoru Murata
  • Hidenori Yamaguchi
  • Takahiko Mine
  • Daisuke Yasui
  • Hitoshi Sugihara
  • Hiroyuki Tajima
Original Article



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.


Primary 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 [15] 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.

Informed consent

Written informed consent was obtained from all patients, and the study was approved by the local ethics committee.

Supplementary material

Supplementary material 1 (MP4 7371 kb)


  1. 1.
    Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C, et al. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol. 2006;48:2293–300.CrossRefPubMedGoogle Scholar
  2. 2.
    Douma S, Petidis K, Doumas M, Papaefthimiou P, Triantafyllou A, Kartali N, et al. Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study. Lancet. 2008;371:1921–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Viera AJ, Neutze DM. Diagnosis of secondary hypertension: an age-based approach. Am Fam Physician. 2010;82:1471–8.PubMedGoogle Scholar
  4. 4.
    Sigurjonsdottir HA, Gronowitz M, Andersson O, Eggertsen R, Herlitz H, Sakinis A, et al. Unilateral adrenal hyperplasia is a usual cause of primary hyperaldosteronism. Results from a Swedish screening study. BMC Endocr Disord. 2012;12:17.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Melby JC, Spark RF, Dale SL, Egdahl RH, Kahn PC. Diagnosis and localization of aldosterone-producing adenomas by adrenal-vein catheterization. N Engl J Med. 1967;277:1050–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Auchus RJ, Michaelis C, Wians FH Jr, Dolmatch BL, Josephs SC, Trimmer CK, et al. Rapid cortisol assays improve the success rate of adrenal vein sampling for primary aldosteronism. Ann Surg. 2009;249:318–21.CrossRefPubMedGoogle Scholar
  7. 7.
    Young WF Jr, Klee GG. Primary aldosteronism. Diagnostic evaluation. Endocrinol Metab Clin N Am. 1988;17:367–95.Google Scholar
  8. 8.
    Daunt N. Adrenal vein sampling: how to make it quick, easy, and successful. Radiographics. 2005;25(Suppl 1):S143–58.CrossRefPubMedGoogle Scholar
  9. 9.
    Matsuura T, Takase K, Ota H, Yamada T, Sato A, Satoh F, et al. Radiologic anatomy of the right adrenal vein: preliminary experience with MDCT. AJR Am J Roentgenol. 2008;191:402–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Plank C, Wolf F, Langenberger H, Loewe C, Schoder M, Lammer J. Adrenal venous sampling using Dyna-CT—a practical guide. Eur J Radiol. 2012;81:2304–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Georgiades CS, Hong K, Geschwind JF, Liddell R, Syed L, Kharlip J, et al. Adjunctive use of C-arm CT may eliminate technical failure in adrenal vein sampling. J Vasc Interv Radiol. 2007;18:1102–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Kinnison M. Adrenal vein sampling with C-arm CT. J Vasc Interv Radiol. 2008;19:153 (author reply 153).CrossRefPubMedGoogle Scholar
  13. 13.
    Onozawa S, Murata S, Tajima H, Yamaguchi H, Mine T, Ishizaki A, et al. Evaluation of right adrenal vein cannulation by computed tomography angiography in 140 consecutive patients undergoing adrenal venous sampling. Eur J Endocrinol. 2014;170:601–8.CrossRefPubMedGoogle Scholar
  14. 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
  15. 15.
    Rossi GP, Auchus RJ, Brown M, Lenders JW, Naruse M, Plouin PF, et al. An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 2014;63:151–60.CrossRefPubMedGoogle Scholar

Copyright information

© Japan Radiological Society 2016

Authors and Affiliations

  1. 1.Department of Radiology/Centre for Advanced Medical TechnologyNippon Medical SchoolBunkyo-kuJapan
  2. 2.Department of Radiology, Tokai University Hachioji HospitalTokai University School of MedicineIseharaJapan
  3. 3.Division of Diabetes, Endocrinology and Metabolism, Department of MedicineNippon Medical SchoolBunkyo-kuJapan

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