title: Right adrenal venography findings correlated with C-arm CT for selection during C-arm CT-assisted adrenal vein sampling in primary aldosteronism.
abstract: OBJECTIVE
  This study was designed to evaluate retrospectively the efficacy of C-arm CT to confirm right adrenal vein catheterization during adrenal vein sampling (AVS) and to correlate adrenal venography findings with C-arm CT and/or biochemical results for right adrenal vein selection.
  
  
  METHODS
  Forty-two consecutive primary aldosteronism patients (M:F = 21:21; age: 29-70 years) underwent C-arm CT assisted sequential AVS. After catheterization of right adrenal vein, C-arm CT was performed to confirm catheter position. Catheter was repositioned when right adrenal gland was not opacified. Radiological images, medical records, and biochemical results were reviewed for technical/biochemical success rates and complications. Right adrenal venography findings of pinnate pattern, visualization of renal capsular vein, and retroperitoneal vein other than renal capsular vein were correlated with C-arm CT and/or biochemical results for right adrenal vein selection.
  
  
  RESULTS
  Both the technical and biochemical success of AVS was achieved in 40 patients (95.2%). C-arm CT failed due to catheter instability in one, and adrenal/vena cava cortisol gradient was <3 in one patient. Catheter was repositioned in four patients (9.5%) according to C-arm CT findings. Right adrenal venography finding of renal capsular vein significantly correlated with C-arm CT and/or biochemical results (100%) for right adrenal vein selection (p = 0.011, χ(2) test), whereas pinnate pattern (p = 0.099) and other retroperitoneal veins (p = 0.347) did not. There was no procedure-related complication.
  
  
  CONCLUSIONS
  C-arm CT increases confidence of right adrenal vein catheterization during AVS. Visualization of renal capsular vein on adrenal venography suggests right adrenal vein catheterization and C-arm CT may not be required.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea, astarte@yuhs.ac.
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Park
authors.forename: Yumie
authors.initials: Y
authors.lastname: Rhee
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Lim
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Mu Sook
authors.initials: MS
authors.lastname: Lee
authors.forename: Myungsu
authors.initials: M
authors.lastname: Lee
authors.forename: Shin Jae
authors.initials: SJ
authors.lastname: Lee
authors.forename: Il Jung
authors.initials: IJ
authors.lastname: Kim
authors.forename: Do Yun
authors.initials: DY
authors.lastname: Lee
authors.forename: June-Sik
authors.initials: JS
authors.lastname: Cho
mesh_terms: D000311:Adrenal Glands / Q000098:blood supply*; D000328:Adult; D000368:Aged; D002404:Catheterization; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D011860:Radiography, Abdominal; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*