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Non-stimulated adrenal venous sampling using Dyna computed tomography in patients with primary aldosteronism

View Article: PubMed Central - PubMed

ABSTRACT

In this retrospective study, we aimed to examine the effect of applying Dyna computed tomography (CT) on the success rate of adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. A total of 100 consecutive patients with primary aldosteronism who underwent AVS between May 2012 and July 2015 were enrolled. In all the cases, Dyna CT was used in AVS to validate catheter position in the right adrenal vein. A selectivity index (cortisoladrenal vein /cortisolinferior vena cava) of ≥2.0 of both adrenal veins were required for successful AVS. Dyna CT indicated misplaced catheters in 16 patients; of these patients, 75% (12/16) eventually had successful right AVS after catheter repositioning. The success rate of initial sampling at the right adrenal vein was 76% (76/100), which increased to 88% (88/100) after Dyna CT was applied (p < 0.001). The most common inadvertently catheterised vessels detected using Dyna CT were the accessory hepatic veins (56.3%, 9/16), followed by the renal capsular veins (37.5%, 6/16). The overall success rate of non-stimulated AVS using Dyna CT was 87% (87/100). Thus, the application of Dyna CT further increased the success rate of non-stimulated AVS.

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A 57-year-old man with primary aldosteronism and bilateral adrenal nodules.(a) On Dyna computed tomography maximum intensity projection imaging in the coronal plane, the renal capsular vein was opacified with the venous orifice at the T11/12 intervertebral level. (b) After adjustment of the catheter position, the right adrenal vein was opacified with the venous orifice at the mid T11 vertebral level.
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f4: A 57-year-old man with primary aldosteronism and bilateral adrenal nodules.(a) On Dyna computed tomography maximum intensity projection imaging in the coronal plane, the renal capsular vein was opacified with the venous orifice at the T11/12 intervertebral level. (b) After adjustment of the catheter position, the right adrenal vein was opacified with the venous orifice at the mid T11 vertebral level.

Mentions: Dyna CT was conducted to confirm the catheter position in the right adrenal vein in all cases. The success rate of initial sampling in the right adrenal vein was 76% (76/100), which increased to 88% (88/100) after Dyna CT and on-site re-sampling (pā€‰<ā€‰0.001; Fig. 2). Catheter misplacement was detected by Dyna CT in 16% (16/100) patients; of these patients, 75% (12/16) eventually had successful sampling after catheter repositioning. On the Dyna CT images, the misplaced catheters were located in the accessory hepatic vein in 8 patients (56.3%, 9/16; Fig. 3), renal capsular vein in 5 patients (37.5%, 6/16; Fig. 4), and inferior phrenic vein in 1 patient (6.3%, 1/16; Fig. 5).


Non-stimulated adrenal venous sampling using Dyna computed tomography in patients with primary aldosteronism
A 57-year-old man with primary aldosteronism and bilateral adrenal nodules.(a) On Dyna computed tomography maximum intensity projection imaging in the coronal plane, the renal capsular vein was opacified with the venous orifice at the T11/12 intervertebral level. (b) After adjustment of the catheter position, the right adrenal vein was opacified with the venous orifice at the mid T11 vertebral level.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120298&req=5

f4: A 57-year-old man with primary aldosteronism and bilateral adrenal nodules.(a) On Dyna computed tomography maximum intensity projection imaging in the coronal plane, the renal capsular vein was opacified with the venous orifice at the T11/12 intervertebral level. (b) After adjustment of the catheter position, the right adrenal vein was opacified with the venous orifice at the mid T11 vertebral level.
Mentions: Dyna CT was conducted to confirm the catheter position in the right adrenal vein in all cases. The success rate of initial sampling in the right adrenal vein was 76% (76/100), which increased to 88% (88/100) after Dyna CT and on-site re-sampling (pā€‰<ā€‰0.001; Fig. 2). Catheter misplacement was detected by Dyna CT in 16% (16/100) patients; of these patients, 75% (12/16) eventually had successful sampling after catheter repositioning. On the Dyna CT images, the misplaced catheters were located in the accessory hepatic vein in 8 patients (56.3%, 9/16; Fig. 3), renal capsular vein in 5 patients (37.5%, 6/16; Fig. 4), and inferior phrenic vein in 1 patient (6.3%, 1/16; Fig. 5).

View Article: PubMed Central - PubMed

ABSTRACT

In this retrospective study, we aimed to examine the effect of applying Dyna computed tomography (CT) on the success rate of adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. A total of 100 consecutive patients with primary aldosteronism who underwent AVS between May 2012 and July 2015 were enrolled. In all the cases, Dyna CT was used in AVS to validate catheter position in the right adrenal vein. A selectivity index (cortisoladrenal vein /cortisolinferior vena cava) of &ge;2.0 of both adrenal veins were required for successful AVS. Dyna CT indicated misplaced catheters in 16 patients; of these patients, 75% (12/16) eventually had successful right AVS after catheter repositioning. The success rate of initial sampling at the right adrenal vein was 76% (76/100), which increased to 88% (88/100) after Dyna CT was applied (p&thinsp;&lt;&thinsp;0.001). The most common inadvertently catheterised vessels detected using Dyna CT were the accessory hepatic veins (56.3%, 9/16), followed by the renal capsular veins (37.5%, 6/16). The overall success rate of non-stimulated AVS using Dyna CT was 87% (87/100). Thus, the application of Dyna CT further increased the success rate of non-stimulated AVS.

No MeSH data available.


Related in: MedlinePlus