Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, Japan.
Department of Diagnostic Radiology, South Miyagi Medical Center, Ohgawara, Miyagi, Japan.
J Vasc Interv Radiol. 2023 Nov;34(11):1963-1969. doi: 10.1016/j.jvir.2023.07.021. Epub 2023 Jul 31.
To assess the diagnostic performance of carbon dioxide (CO) and intraprocedural unenhanced computed tomography (CT) for adrenal venous sampling (AVS) (CO-intraprocedural unenhanced CT-AVS) in patients with primary aldosteronism (PA) and a history of iodine contrast medium allergy.
CO-intraprocedural unenhanced CT-AVS was performed in 18 patients with iodine contrast media allergies at the authors' hospital between December 2015 and January 2021. CT and noncontrast magnetic resonance angiography were used to evaluate the preoperative adrenal vein anatomy. CO venography was performed to confirm adrenal vein catheterization. Additionally, intraprocedural unenhanced CT was also performed to confirm catheter position in the right adrenal gland.
In all cases in which CO-intraprocedural unenhanced CT-AVS was performed, the right and left adrenal veins were catheterized appropriately, leading to a localized diagnosis. Catheterization of the left adrenal vein was confirmed using CO venography in all cases. In 7 of the 18 cases, CO venography demonstrated selection of the right adrenal vein. In 15 of 18 cases, intraprocedural unenhanced CT demonstrated selection of the right adrenal vein.
CO-intraprocedural unenhanced CT-AVS demonstrated the same diagnostic ability for PA localization as conventional AVS with iodine contrast media. The proposed method is clinically feasible for AVS, in which iodine contrast media use is restricted.
评估二氧化碳（CO）和术中非增强计算机断层扫描（CT）在有碘对比剂过敏史的原发性醛固酮增多症（PA）患者中的肾上腺静脉采样（AVS）（CO-术中非增强 CT-AVS）的诊断性能。
2015 年 12 月至 2021 年 1 月，作者医院对 18 例碘对比剂过敏患者进行了 CO-术中非增强 CT-AVS。CT 和非增强磁共振血管造影术用于评估术前肾上腺静脉解剖结构。CO 血管造影术用于确认肾上腺静脉导管插入。此外，还进行了术中非增强 CT 以确认导管在右肾上腺中的位置。
在所有进行 CO-术中非增强 CT-AVS 的病例中，右肾上腺静脉和左肾上腺静脉均适当导管插入，导致局部诊断。在所有病例中，CO 血管造影术均确认了左肾上腺静脉的导管插入。在 18 例中有 7 例中，CO 血管造影术显示了右肾上腺静脉的选择。在 18 例中有 15 例，术中非增强 CT 显示了右肾上腺静脉的选择。
CO-术中非增强 CT-AVS 对 PA 定位的诊断能力与常规碘对比剂增强 CT-AVS 相同。对于限制使用碘对比剂的 AVS，该方法在临床上是可行的。
