Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

CT mapping of the vertebral level of right adrenal vein

1.

Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.

2.

Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.

Diagn Interv Radiol 2015; 21: 60-66
DOI: 10.5152/dir.2014.14026
Read: 528 Downloads: 121 Published: 03 September 2019

Abstract

PURPOSE

We aimed to evaluate the accuracy of multidetector computed tomography (MDCT) venous mapping for the localization of the right adrenal veins (RAV) in patients suffering from primary aldosteronism.

 

METHODS

MDCT scans of 75 patients with primary aldosteronism between March 2008 and November 2011 were evaluated by two readers (a junior [R1] and a senior [R2] radiologist) according to the following criteria: quality of RAV depiction (scale, 1–5), localization of the RAV confluence with regard to the inferior vena cava, and depiction of anatomical variants. Results were compared with RAV venograms obtained during adrenal vein sampling and corroborated by laboratory testing of cortisol in selective RAV blood samples. Kappa statistics were calculated for interobserver agreement and for concordance of MDCT mapping with the gold standard.

 

RESULTS

Successful RAV sampling was achieved in 69 of 75 patients (92%). Using MDCT mapping, adrenal veins could be visualized in 78% (R1, 54/69) and 77% (R2, 53/69) of patients. MDCT mapping led to correct identification of RAV in 70% (R1, 48/69) and 88% (R2, 61/69) of patients. Venograms revealed five cases of anatomical variants, which were correctly identified in 60% (R1, R2). MDCT-based localizations were false or misleading in 16% (R1, 11/69) and 7% (R2, 5/69) of cases.

 

CONCLUSION

Preinterventional MDCT mapping may facilitate successful catheterization in adrenal vein sampling.

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