title: Non-stimulated adrenal venous sampling using Dyna computed tomography in patients with primary aldosteronism.
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.
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chin-Chen
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Bo-Ching
authors.initials: BC
authors.lastname: Lee
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Kao-Lang
authors.initials: KL
authors.lastname: Liu
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yeun-Chung
authors.initials: YC
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.affiliation: Department of Urology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Kuo-How
authors.initials: KH
authors.lastname: Huang
mesh_terms: D000311:Adrenal Glands / Q000098:blood supply* / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D002404:Catheterization; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*