CT during Arteriography to Visualize the Right Adrenal Vein for Adrenal Venous Sampling

Oguro, Sota; Nakatsuka, Seishi; Yashiro, Hideki; Hashimoto, Subaru; Miyashita, Kazutoshi; Kurihara, Isao; Itoh, Hiroshi; Jinzaki, Masahiro

doi:10.1016/j.jvir.2015.02.008

Cited by 7 publications

(6 citation statements)

References 9 publications

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“…The vertebral body is usually used as a landmark for localizing the RAV orifice. In the present study, we consistently demonstrated that the RAV orifice was mainly distributed from T11 to T12 as previously reported [ 4 , 5 ]. However, such an approximate range seemed broad while comparing to the tiny RAV orifice.…”

Section: Discussionsupporting

confidence: 92%

“…However, such an approximate range seemed broad while comparing to the tiny RAV orifice. Pre-operative enhanced CT scans might contribute to demonstrate the localization of RAV orifice relative to the vertebral body [ 4 , 10 ]. However, the vessel is sometimes blurred on CT imaging, and not all the vessel can be detected.…”

Section: Discussionmentioning

confidence: 99%

“…The RAV orifice often lies between the 11 th and 12 th vertebral body, that can be considered as an anatomic landmark based on the imageology studies [ 4 , 5 ]. Identifying the kidney contour on fluoroscopy might also contributes to localize the approximate location of the RAV [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Use the right kidney contour as a landmark in adrenal vein sampling

Qian

Du²,

Ye³

et al. 2022

PLoS ONE

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Adrenal Vein Sampling (AVS) is the gold standard for categorizing primary aldosteronism (PA). However, catheterization of the right adrenal vein (RAV) is challenging due the small size and variable location. This study aims to explore the relationship between the RAV orifice and the right kidney contour (RKC) on fluoroscopy, thus evaluating the potential of use the RKC as an anatomic marker for localizing RAV. Imaging data of 107 PA patients with successful bilateral AVS were retrospectively analyzed. Based on the body mass index (BMI), all patients were divided into the Normal Group (BMI < 24 kg/m2), Overweight Group (24 kg/m2 ≤ BMI < 28 kg/m2) and Obese Group (BMI ≥ 28 kg/m2). At the anterior view, the height level of RAV orifice was determined relative to vertebral bodies and disks. The distance from the RAV orifice to the upper edge of RKC was measured manually. The RAV orifice height level was mainly distributed from vertebral T11 to T12 (90.6%), and tended to be higher in patients with a larger BMI. The mean distance from the RAV orifice to the upper edge of RKC was 13.9±7.8mm, and had no difference among Normal group (n = 53, 14.1±8.2mm), Overweight group (n = 39, 13.7±8.0mm), and Obese group (n = 15, 13.9±5.5mm) (p = 0.981). Based on these findings, the RKC might be used as a landmark for localizing RAV on fluoroscopy, which is conductive to narrow down the exploration range and increase the success rate of RAV catheterization.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Use the right kidney contour as a landmark in adrenal vein sampling

Qian

Du²,

Ye³

et al. 2022

PLoS ONE

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“…Thus, it is necessary to be careful with suitable anatomical information from AMI. In the literature, CT during arteriography and C-arm CT have been reported to be feasible and useful in identifying the location and direction of the right adrenal vein for AVS (16,17). However, these examinations are useful to confirm whether the catheterized vein is really the right adrenal vein.…”

Section: Discussionmentioning

confidence: 99%

Advanced monoenergetic reconstruction technique in dual-energy computed tomography for evaluation of vascular anatomy before adrenal vein sampling

et al. 2019

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Background In adrenal vein sampling, selecting the right adrenal vein is technically difficult and it is important to evaluate the right adrenal vein anatomy before adrenal vein sampling. The advanced monoenergetic reconstruction technique has recently become available and we hypothesized that this technique may be useful. Purpose To evaluate the usefulness of the advanced monoenergetic reconstruction technique in dual-energy computed tomography (CT; advanced monoenergetic images) for evaluation of vascular anatomy before adrenal vein sampling. Material and Methods Twenty-one patients underwent three-phase (20, 30, and 70 s) contrast-enhanced CT before adrenal vein sampling. Advanced monoenergetic images were reconstructed at 40 keV and analyzed objectively and subjectively in comparison with the standard 120-kVp images. As objective evaluation, the signal-to-noise ratio and contrast-to-noise ratio of the right adrenal vein were assessed. As subjective evaluation, two radiologists assessed the delineation of the right adrenal vein using a 5-point Likert scale (1 = poor, 5 = excellent). Furthermore, the technical success rate of adrenal vein sampling and procedure time were also evaluated. Results There was no difference in the signal-to-noise ratio between the two groups. The contrast-to-noise ratios of the right adrenal vein of advanced monoenergetic images were higher than those of the standard images ( P < 0.05). The Likert scores of advanced monoenergetic images were higher than those of the standard images ( P < 0.05). The technical success rate of adrenal vein sampling was 95% (20/21) and the median of procedure time was 103 min (range = 59–197 min). Conclusion Advanced monoenergetic imaging appears to be useful in the delineation of the right adrenal vein before adrenal vein sampling.

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“…8,9 Several prior studies have investigated facilitating cannulation using preoperative computed tomography (CT) mapping, intraoperative CT angiography, and different wire-catheter selection techniques. 6,[9][10][11][12][13] While right-sided cannulation is considered more cumbersome with higher failure rates, left-sided failures occur in as many as 39% of unsuccessful cases. 6,14 Reliable landmarks allow improved confidence of correct catheter placement and hence improved "target" sampling of the desired vessel.…”

Section: Introductionmentioning

confidence: 99%

Use of Bony Landmarks during Adrenal Venous Sampling to Guide Catheterization of the Left Adrenal Vein

Cusumano

Mathevosian

Sweigert

et al. 2021

The Arab Journal of Interventional Radiology

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Purpose The aim of this study was to examine the utility of fluoroscopic bony landmarks in predicting the location of the left adrenal vein during adrenal vein sampling (AVS). Methods Eighty-six AVS procedures were performed in 81 patients between August 2013 and March 2020. A selectivity index was calculated for each case by dividing the measured left adrenal vein cortisol level by the peripheral vein cortisol level. Successful “target” left adrenal vein catheterization was confirmed in cases with a selectivity index of three or greater. Intraprocedural AVS fluoroscopic images were selected that demonstrated catheter position in the left adrenal vein. Lateral distance from the catheter tip in the left adrenal vein to the lateral margin of the left pedicle at the associated vertebral body level was measured. Results Mean patient age was 56.4 years (range: 19–80 years) and 48 (59.3%) patients were male. Target sampling in the left adrenal vein was confirmed in 82 (95.3%) cases. In 78 (95.1%) targeted cases, the catheter terminated less than 25 mm from the left lateral pedicle at a mean distance of 11.2 mm. The catheter was most frequently placed at the T12 and L1 vertebral body levels. Four (4.7%) cases demonstrated nontarget catheter positioning, two (50.0%) of these cases were within 25 mm. Conclusion The position of the left adrenal vein is generally located in a predictable position relative to bony landmarks. By utilizing these landmarks, positioning of the sampling catheter during AVS can be more reliable with the potential to avoid repeat procedures and delays in patient care.

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CT during Arteriography to Visualize the Right Adrenal Vein for Adrenal Venous Sampling

Cited by 7 publications

References 9 publications

Use the right kidney contour as a landmark in adrenal vein sampling

Use the right kidney contour as a landmark in adrenal vein sampling

Advanced monoenergetic reconstruction technique in dual-energy computed tomography for evaluation of vascular anatomy before adrenal vein sampling

Use of Bony Landmarks during Adrenal Venous Sampling to Guide Catheterization of the Left Adrenal Vein

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