title: Comparison of the central adrenal vein and the common trunk of the left adrenal vein for adrenal venous sampling.
abstract: OBJECTIVE
  To compare left adrenal venous sampling (AVS) in two locations: the central adrenal vein and the common trunk.
  
  
  METHODS
  A total of 22 patients (12 men and 10 women; mean age, 50 y; range, 26-65 y) who were suspected of having primary aldosteronism (PA) and underwent successful AVS with cortisol concentration measurement and/or venography between November 2010 and August 2011 were retrospectively analyzed. In regard to the left adrenal vein, collections were done at two locations: at the common trunk below the confluence of the inferior phrenic vein and at the central adrenal vein, which was above the confluence. The effects of the inflow from the inferior phrenic vein on plasma aldosterone and cortisol levels were analyzed.
  
  
  RESULTS
  Eight patients had bilateral hypersecreting lesions and 13 had a unilateral lesion. One was diagnosed as having secondary hypertension other than PA. The median cortisol levels below and above the confluence were 129 μg/dL (range, 21-400 μg/dL) and 215 μg/dL (range, 21-690 μg/dL), respectively. The median aldosterone levels were 2,120 pg/mL (range, 164-42,700 pg/mL) and 4,275 pg/mL (range, 119-59,000 pg/mL), respectively. The median aldosterone/cortisol (A/C) ratios were 244 (range, 34-2,401) and 278 (range, 25-2,251), respectively. Cortisol and aldosterone levels were significantly higher above the confluence (P = .0050 and P = .0003, respectively), whereas the A/C ratio showed no significant difference (P = .12).
  
  
  CONCLUSIONS
  Although higher levels of cortisol and aldosterone were obtained upstream, A/C ratio was not significantly different between the central adrenal vein and the common trunk.
authors.affiliation: Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan. akira-t@mvd.biglobe.ne.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Takada
authors.forename: Kojiro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yoshine
authors.initials: Y
authors.lastname: Mori
authors.forename: Ryota
authors.initials: R
authors.lastname: Hyodo
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kawakami
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Okochi
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
mesh_terms: D000311:Adrenal Glands / Q000098:blood supply*; D000328:Adult; D000450:Aldosterone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001800:Blood Specimen Collection / Q000379:methods*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D006929:Hyperaldosteronism / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D012189:Retrospective Studies; D014680:Veins
chemical_list: D015415:Biomarkers; D000450:Aldosterone; D006854:Hydrocortisone