Ota Hideki, Seiji Kazumasa, Kawabata Masahiro, Satani Nozomi, Omata Kei, Ono Yoshikiyo, Iwakura Yoshitsugu, Morimoto Ryo, Matsuura Tomonori, Kudo Masataka, Tominaga Junya, Satoh Fumitoshi, Ito Sadayoshi, Takase Kei
Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Eur Radiol. 2016 Mar;26(3):622-30. doi: 10.1007/s00330-015-3872-3. Epub 2015 Jun 25.
To evaluate visualization of the right adrenal vein (RAV) with multidetector CT and non-contrast-enhanced MR imaging in patients with primary aldosteronism.
A total of 125 patients (67 men) scheduled for adrenal venous sampling (AVS) were included. Dynamic 64-detector-row CT and balanced steady-state free precession-based non-contrast-enhanced 3-T MR imaging were performed. RAV visualization based on a four-point score was documented. Both anatomical location and variation on cross-sectional imaging were evaluated, and the findings were compared with catheter venography as the gold standard.
The RAV was visualized in 93.2% by CT and 84.8% by MR imaging (p = 0.02). Positive predictive values of RAV visualization were 100% for CT and 95.2% for MR imaging. Imaging score was significantly higher in CT than MR imaging (p < 0.01). The RAV formed a common trunk with an accessory hepatic vein in 16% of patients. The RAV orifice level on cross-sectional imaging was concordant with catheter venography within the range of 1/3 vertebral height in >70% of subjects. Success rate of AVS was 99.2%.
Dynamic CT is a reliable way to map the RAV prior to AVS. Non-contrast-enhanced MR imaging is an alternative when there is a risk of complication from contrast media or radiation exposure.
Dynamic CT and non-contrast-enhanced MR imaging detect the right adrenal vein (RAV). Dynamic CT can visualize the RAV more than non-contrast-enhanced MR imaging. Mapping the RAV helps to achieve successful adrenal venous sampling. Sixteen per cent of RAVs share the common trunk with accessory hepatic veins.
评估多排CT及非增强磁共振成像对原发性醛固酮增多症患者右肾上腺静脉（RAV）的显示情况。
纳入125例计划行肾上腺静脉采血（AVS）的患者（67例男性）。行64排动态CT及基于稳态自由进动序列的非增强3T磁共振成像检查。记录基于四点评分的RAV显示情况。评估横断面成像上的解剖位置及变异情况，并将结果与作为金标准的导管静脉造影进行比较。
CT对RAV的显示率为93.2%，磁共振成像为84.8%（p = 0.02）。CT对RAV显示的阳性预测值为100%，磁共振成像为95.2%。CT成像评分显著高于磁共振成像（p < 0.01）。16%的患者RAV与副肝静脉形成共同主干。横断面成像上RAV开口水平与导管静脉造影在>70%的受试者中在1/3椎体高度范围内一致。AVS成功率为99.2%。
动态CT是AVS前显示RAV的可靠方法。当存在造影剂并发症风险或辐射暴露风险时，非增强磁共振成像是一种替代方法。
动态CT和非增强磁共振成像可检测右肾上腺静脉（RAV）。动态CT比非增强磁共振成像更能清晰显示RAV。显示RAV有助于成功进行肾上腺静脉采血。16%的RAV与副肝静脉共用共同主干。
