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[原发性醛固酮增多症中的肾上腺静脉采血：左侧最佳采血的图文综述]

[Adrenal Vein Sampling in Primary Aldosteronism: A Pictorial Essay for Optimal Left-Side Sampling].

作者信息

Kim Gi Joo, Kim Myung Sub, Hong Hyun Pyo, Lee Young Rae, Choi Yeon Gyu

出版信息

J Korean Soc Radiol. 2023 Mar;84(2):386-397. doi: 10.3348/jksr.2021.0188. Epub 2022 Nov 10.

DOI:10.3348/jksr.2021.0188
PMID:37051402
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10083640/
Abstract

Primary aldosteronism (PA) is a curable cause of hypertension. Recent studies have revealed that the actual prevalence of PA is higher than previously recognized. Adrenal vein sampling (AVS) is an essential diagnostic procedure for revealing the cause of PA and determining the treatment plan. The success of AVS is confirmed by comparing cortisol levels between the samples from each adrenal vein and peripheral vein. The failure rate of the procedure is reported to be high in the right adrenal vein, which is directly connected to the inferior vena cava, while that in the left adrenal vein is relatively low; however, this has rarely been reported. In this review, we introduce and analyze cases of failure in left adrenal vein sampling.

摘要

原发性醛固酮增多症（PA）是高血压的一个可治愈病因。近期研究表明，PA的实际患病率高于此前认知。肾上腺静脉采样（AVS）是明确PA病因及确定治疗方案的关键诊断程序。通过比较来自每条肾上腺静脉和外周静脉的样本中的皮质醇水平来确认AVS是否成功。据报道，直接与下腔静脉相连的右侧肾上腺静脉采样的失败率较高，而左侧肾上腺静脉采样的失败率相对较低；然而，这方面的报道很少。在本综述中，我们介绍并分析左侧肾上腺静脉采样失败的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/3ee2a72bb655/jksr-84-386-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/75914e5d19af/jksr-84-386-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/e8e5e5cd28e5/jksr-84-386-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/2d3df412bec4/jksr-84-386-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/a9452bc8120d/jksr-84-386-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/3ee2a72bb655/jksr-84-386-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/75914e5d19af/jksr-84-386-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/e8e5e5cd28e5/jksr-84-386-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/2d3df412bec4/jksr-84-386-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/a9452bc8120d/jksr-84-386-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f9/10083640/3ee2a72bb655/jksr-84-386-g005.jpg

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本文引用的文献

1
Reduction of Radiation Exposure in Adrenal Vein Sampling: Impact of the Rapid Cortisol Assay.降低肾上腺静脉采样中的辐射暴露：快速皮质醇检测的影响。
Rofo. 2021 Dec;193(12):1392-1402. doi: 10.1055/a-1535-2566. Epub 2021 Aug 12.
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Adrenal vein sampling: technique and protocol, a systematic review.肾上腺静脉采血：技术与方案，一项系统评价
CVIR Endovasc. 2021 Apr 1;4(1):38. doi: 10.1186/s42155-021-00220-y.
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Utility of microcatheter in adrenal venous sampling for primary aldosteronism.微导管在原发性醛固酮增多症肾上腺静脉采样中的应用。
Br J Radiol. 2020 May 1;93(1109):20190636. doi: 10.1259/bjr.20190636. Epub 2020 Feb 28.
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Adrenal Venous Sampling: Where Do We Stand?肾上腺静脉采血：我们处于何种境地？
Endocrinol Metab Clin North Am. 2019 Dec;48(4):843-858. doi: 10.1016/j.ecl.2019.08.012. Epub 2019 Sep 25.
5
Adrenal vein sampling with and without cosyntropin stimulation for detection of surgically remediable aldosteronism.在有和没有促肾上腺皮质激素刺激的情况下进行肾上腺静脉采血以检测可手术治愈的醛固酮增多症。
Endocrinol Diabetes Metab. 2019 Mar 7;2(2):e00066. doi: 10.1002/edm2.66. eCollection 2019 Apr.
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Anatomical Variations of the Right Adrenal Vein: Concordance Between Multidetector Computed Tomography and Catheter Venography.右肾上腺静脉的解剖变异：多层螺旋计算机断层扫描与导管静脉造影的一致性
Hypertension. 2017 Mar;69(3):428-434. doi: 10.1161/HYPERTENSIONAHA.116.08375. Epub 2017 Jan 30.
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SFE/SFHTA/AFCE consensus on primary aldosteronism, part 1: Epidemiology of PA, who should be screened for sporadic PA?SFE/SFHTA/AFCE关于原发性醛固酮增多症的共识，第1部分：PA的流行病学，谁应该接受散发性PA的筛查？
Ann Endocrinol (Paris). 2016 Jul;77(3):187-91. doi: 10.1016/j.ando.2016.01.006. Epub 2016 Apr 15.
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Basal and Post-ACTH Aldosterone and Its Ratios Are Useful During Adrenal Vein Sampling in Primary Aldosteronism.基础及促肾上腺皮质激素刺激后的醛固酮水平及其比值在原发性醛固酮增多症的肾上腺静脉采血检查中具有重要作用。
J Clin Endocrinol Metab. 2016 Apr;101(4):1826-35. doi: 10.1210/jc.2015-3915. Epub 2016 Feb 26.
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Intra-adrenal Aldosterone Secretion: Segmental Adrenal Venous Sampling for Localization.肾上腺内醛固酮分泌：用于定位的肾上腺段静脉采样。
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