PDF(Pubmed)
Abstract：
Accurate cannulation of the adrenal vein is challenging during adrenal venous sampling (AVS) because of the variations in adrenal vein anatomy. This study aimed to investigate the adrenal venous morphology in Chinese and improve the success rate of AVS. A total of 221 participants with primary aldosteronism (PA) who underwent AVS were enrolled. Compare the morphology among subgroups divided according to sex, body mass index (BMI), and with or without adenoma. The success rate of right, left, and bilateral AVS was 98.60%, 97.20%, and 96.85%, respectively. The triangular pattern was the most common (39.37%) on the right side, while the glandlike pattern (70.14%) on the left. The proportion of adrenal venous morphology varies among patients with different sexes (χ2 = 21.335, P < .001), BMI (χ2 = 10.642 P = .031), and with or without adenoma (χ2 = 10.637, P = .031) on the right side, and the male, obese and adenoma group showed a higher proportion of glandlike pattern than triangular pattern. If only dependent on computed tomography, 9.05% of patients incorrectly diagnose the dominant side, 14.48% of patients would have inappropriate surgery meanwhile 25.34% of patients would miss the surgical opportunity. In conclusion, the most common types of right and left adrenal venous morphology were triangular pattern and glandlike pattern, respectively. Sex, BMI, and the presence of adenoma affected right adrenal venous morphology. Adequate knowledge of the adrenal venous morphology is critical for improving the success rate of AVS and making an appropriate treatment for PA.
摘要：
由于肾上腺静脉解剖结构的变化，在肾上腺静脉采样（AVS）期间，肾上腺静脉的准确插管具有挑战性。本研究旨在探讨国人肾上腺静脉形态特征,提高AVS的成功率。共纳入221名接受AVS的原发性醛固酮增多症（PA）患者。比较按性别划分的亚组的形态，体重指数（BMI），有或没有腺瘤。正确的成功率，左,双侧AVS为98.60%，97.20%,和96.85%，分别。右侧最常见的是三角形图案(39.37%),而左侧为腺样模式(70.14%)。不同患者肾上腺静脉形态的比例不同(χ2=21.335,P<.001),BMI（χ2=10.642P=0.031），右侧有或没有腺瘤（χ2=10.637，P=0.031），而男性，肥胖和腺瘤组显示腺样模式的比例高于三角形模式。如果仅仅依靠计算机断层扫描,9.05%的患者错误地诊断优势侧，14.48％的患者会进行不适当的手术，而25.34％的患者会错过手术机会。总之,左右肾上腺静脉形态最常见的类型是三角形和腺样，分别。性,BMI,腺瘤的存在影响右肾上腺静脉形态。对肾上腺静脉形态的充分了解对于提高AVS的成功率和对PA进行适当的治疗至关重要。
