Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
Endocrine. 2013 Feb;43(1):219-24. doi: 10.1007/s12020-012-9792-y. Epub 2012 Sep 13.
The aim of this study was to retrospectively examine adrenal venous catecholamine concentrations and related indices in non-pheochromocytoma patients and to estimate from the obtained results whether measurements of adrenal venous catecholamine concentrations by adrenal venous sampling (AVS) are useful for localizing adrenal pheochromocytoma. The study population comprised 15 patients in whom AVS was performed for evaluation of adrenal non-pheochromocytoma masses (primary aldosteronism, n = 8; Cushing syndrome, n = 5; non-hyperfunctioning tumor, n = 2) without hormonal intervention and was successful in bilaterally judging adrenal vein to infra-renal inferior vena cava cortisol ratios as >3.0. Wide ranges of catecholamine concentrations were seen for both right (epinephrine, 35-175,821 pg/ml; norepinephrine, 115-32,102 pg/ml; dopamine, 9-232 pg/ml) and left (epinephrine, 16-27,251 pg/ml; norepinephrine, 155-9,267 pg/ml; dopamine, 5-234 pg/ml) adrenal veins. High- to low-side adrenal vein concentration ratios also showed wide ranges of up to 779 for epinephrine, 22.5 for norepinephrine, and 7.8 for dopamine. Adrenal venous catecholamine concentrations obtained by AVS and simple comparisons between bilateral adrenal veins might not be useful to localize adrenal pheochromocytoma, as wide variations in concentrations and high- to low-side adrenal vein concentration ratios were noted in patients with adrenal non-pheochromocytoma.
本研究旨在回顾性检查非嗜铬细胞瘤患者的肾上腺静脉儿茶酚胺浓度和相关指标,并根据获得的结果评估肾上腺静脉取样(AVS)测量肾上腺静脉儿茶酚胺浓度是否有助于定位肾上腺嗜铬细胞瘤。研究人群包括 15 名因评估肾上腺非嗜铬细胞瘤肿块(原发性醛固酮增多症,n = 8;库欣综合征,n = 5;无功能肿瘤,n = 2)而进行 AVS 的患者,且双侧肾上腺静脉至肾下腔静脉皮质醇比值均>3.0,AVS 成功进行。右侧(肾上腺素,35-175821pg/ml;去甲肾上腺素,115-32102pg/ml;多巴胺,9-232pg/ml)和左侧(肾上腺素,16-27251pg/ml;去甲肾上腺素,155-9267pg/ml;多巴胺,5-234pg/ml)肾上腺静脉的儿茶酚胺浓度均存在广泛的范围。高侧到低侧肾上腺静脉浓度比也高达肾上腺素 779,去甲肾上腺素 22.5,多巴胺 7.8。AVS 获得的肾上腺静脉儿茶酚胺浓度和双侧肾上腺静脉之间的简单比较可能无助于定位肾上腺嗜铬细胞瘤,因为在肾上腺非嗜铬细胞瘤患者中,浓度和高侧到低侧肾上腺静脉浓度比存在广泛的变化。