Xiong Hong-Liang, Du Li, Yang Jiao, Hu Wei-Tong, Huang Jia-Bing, Li Yun-De, Chen Xi, Dong Yi-Fei
Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Donghu District, P.R. China.
Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Donghu District, P.R. China.
J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14978. doi: 10.1111/jch.14978.
This study aimed to evaluate the visualization of right adrenal vein (RAV) in non-contrast-enhanced multi-detector computed tomography (MDCT) and its guiding role for right adrenal venous sampling (AVS) in patients with primary aldosteronism (PA). A total of 237 patients diagnosed with PA who underwent successful AVS procedures from January 2020 to March 2021 were retrospectively analyzed. The non-contrast-enhanced MDCT image features of RAV included the degree of visualization and the position of RAV orifice. Subsequently, the concordance degree between RAV in non-contrast-enhanced MDCT and AVS images was calculated to evaluate its guiding effect for right AVS. The visualization rate of RAV in non-contrast-enhanced MDCT was 81.9% (n = 194), with 73.7% (n = 143) clearly displayed and 26.3% (n = 51) generally displayed. In 6.2% (n = 12) of patients who can display RAV, RAV formed a common trunk with the accessory hepatic vein and then merged into the inferior vena cava. Non-contrast-enhanced MDCT revealed that RAV orifice was located between the 10th thoracic vertebra (T10) and the 1st lumbar vertebra (L1), with 85.1% (n = 165) located from the lower 1/3 of T11 to the lower 1/3 of T12. The concordance of imaging anatomy of RAV between non-contrast-enhanced MDCT and AVS image was found to be at a high rate of 94.3% (n = 183). Non-contrast-enhanced MDCT provides excellent visualization of RAV and clearly depicts its anatomical characteristics. Furthermore, RAV images obtained from non-contrast-enhanced MDCT are highly consistent with those from AVS, indicating that interpretation of non-contrast-enhanced MDCT before AVS can reduce the failure rate of RAV cannulation.
本研究旨在评估非增强型多排螺旋计算机断层扫描（MDCT）对右肾上腺静脉（RAV）的显影情况及其在原发性醛固酮增多症（PA）患者右肾上腺静脉采样（AVS）中的指导作用。回顾性分析了2020年1月至2021年3月期间共237例诊断为PA且AVS手术成功的患者。RAV的非增强型MDCT图像特征包括显影程度和RAV开口位置。随后，计算非增强型MDCT中RAV与AVS图像之间的符合程度，以评估其对右AVS的指导效果。非增强型MDCT中RAV的显影率为81.9%（n = 194），其中73.7%（n = 143）清晰显示，26.3%（n = 51）大致显示。在6.2%（n = 12）可显示RAV的患者中，RAV与副肝静脉形成共同干，然后汇入下腔静脉。非增强型MDCT显示RAV开口位于第10胸椎（T10）和第1腰椎（L1）之间，85.1%（n = 165）位于T11下1/3至T12下1/3。发现非增强型MDCT与AVS图像中RAV的影像解剖符合率高达94.3%（n = 183）。非增强型MDCT能很好地显示RAV并清晰描绘其解剖特征。此外，非增强型MDCT获得的RAV图像与AVS图像高度一致，表明在AVS前解读非增强型MDCT可降低RAV插管失败率。
