Yu Y, Yang M H, Gong M H, Song W, Jiang Y N, Zhang Y
Department of Hypertension, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2024 Aug 24;52(8):892-898. doi: 10.3760/cma.j.cn112148-20240416-00209.
To analyze the anatomical characteristics of the adrenal veins through adrenal venography to improve the success rate of adrenal venography (AVS). This study was a cross-sectional study. Patients who were diagnosed with primary aldosteronism and underwent AVS from January 2019 to October 2023 at the First Affiliated Hospital of Dalian Medical University were included. Adrenal vein imaging was collected from the enrolled patients. We performed statistical analysis on the adrenal vein orifice position, inflow angle, and adrenal venography morphology. The adrenal venous orifice was defined as the location where the catheter was placed at the end of the calm inhalation. Spearman correlation analysis was used to explore the relationship between the positions of bilateral adrenal vein orifices and body mass index (BMI). A total of 282 patients with successful bilateral AVS and complete bilateral adrenal vein imaging were enrolled, of whom 57.1% (161/282) were male and the age was (53.3±10.7) years old. The orifice of the left adrenal vein was located between the middle segment of the 11 thoracic vertebra and the upper segment of the 2 lumbar vertebra. The inflow angle relative to the position of the orifice was all leftward and upward. The orifice of the right adrenal vein was located between the upper segment of the 11 thoracic vertebra and the lower segment of the 1 lumbar vertebra, and 91.1% (257/282) had a rightward and downward angle of inflow relative to the position of the orifice. The position of the adrenal vein orifices on both the left (0.211, 0.001) and right (=0.196, 0.001) showed positive correlation with BMI. The position of the right adrenal vein orifice also increased with the position of the left adrenal orifice (=0.530, 0.001). The most common adrenal venography morphology on the right side was triangular (36.5%, 103/282), while the most common venography morphology on the left side was glandular (66.3%, 187/282). The anatomical morphology of adrenal veins are diverse. Being familiar with the morphological characteristics of the adrenal vein and identifying the adrenal vein accurately during surgery has important clinical value in improving the success rate of AVS.
通过肾上腺静脉造影分析肾上腺静脉的解剖特征，以提高肾上腺静脉采样（AVS）的成功率。本研究为横断面研究。纳入2019年1月至2023年10月在大连医科大学附属第一医院被诊断为原发性醛固酮增多症并接受AVS的患者。收集纳入患者的肾上腺静脉影像。我们对肾上腺静脉开口位置、流入角度和肾上腺静脉造影形态进行了统计分析。肾上腺静脉开口定义为平静吸气末导管置入的位置。采用Spearman相关性分析探讨双侧肾上腺静脉开口位置与体重指数（BMI）之间的关系。共纳入282例双侧AVS成功且双侧肾上腺静脉影像完整的患者，其中男性占57.1%（161/282），年龄为（53.3±10.7）岁。左肾上腺静脉开口位于第11胸椎中段至第2腰椎上段之间。相对于开口位置的流入角度均向左上方。右肾上腺静脉开口位于第11胸椎上段至第1腰椎下段之间，91.1%（257/282）相对于开口位置有向右下方的流入角度。左（0.211，0.001）、右（=0.196，0.001）肾上腺静脉开口位置与BMI均呈正相关。右肾上腺静脉开口位置也随左肾上腺开口位置的升高而升高（=0.530，0.001）。右侧最常见的肾上腺静脉造影形态为三角形（占36.5%，103/282），而左侧最常见的静脉造影形态为腺状（占66.3%，187/282）。肾上腺静脉的解剖形态多样。熟悉肾上腺静脉的形态特征并在手术中准确识别肾上腺静脉，对提高AVS成功率具有重要临床价值。
