Details

Autor(en) / Beteiligte

• Becker, L. S.
• Hinrichs, M. H.
• Werncke, T.
• Dewald, C. L. A.
• Maschke, S. K.
• Limbourg, F. P.
• Ringe, K. I.
• Hinrichs, J. B.
• Wacker, F.
• Meyer, B. C.

Titel

Adrenal venous sampling in primary hyperaldosteronism: correlation of hormone indices and collimated C-arm CT findings

Ist Teil von

• Abdominal radiology (New York), 2021-07, Vol.46 (7), p.3471-3481

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Purpose To evaluate the feasibility and effect of an approach to adrenal venous sampling (AVS) analysis by combining established selective cortisol and aldosterone indices with the acquisition of a collimated C-arm CT(CACT Coll ). Methods Overall, 107 consecutive patients (45f,62 m; 54 ± 10 years) undergoing 111 AVS procedures without hormonal stimulation from 7/13 to 2/20 in a single institution were retrospectively analysed. Hormone levels were measured in sequential samples of the suspected adrenal veins and right iliac vein, and selectivity indices (SI) computed. Stand-alone SI Cortisol and/or SI Aldosterone  ≥ 2.0 as well as SI Cortisol and/or SI Aldosterone  ≥ 1.1 combined with positive right-sided CACT Coll of the adrenals ( n  = 80; opacified right adrenal vein) were defined as a successful AVS procedure. Radiation exposure of CACT was measured via dose area product (DAP) and weighed against an age-/weight-matched cohort ( n  = 66). Results Preliminary success rates (SI Cortisol and/or SI Aldosterone  ≥ 2.0) were 99.1% (left) and 72.1% (right). These could be significantly increased to a 90.1% success rate on the right, by combining an adjusted SI of 1.1 with a positive CACT Coll proving the correct sampling position. Sensitivity for stand-alone collimated CACT (CACT Coll ) was 0.93, with 74/80 acquired CACT Coll confirming selective cannulation by adrenal vein enhancement. Mean DAP Coll_CACT measured 2414 ± 958 μGyxm 2 , while mean DAP Full-FOV_CACT in the matched cohort measured 8766 ± 1956 μGyxm 2 (p < 0.001). Conclusion Collimated CACT in AVS procedures is feasible and leads to a significant increase in success rates of (right-sided) selective cannulation and may in combination with adapted hormone indices, offer a successful alternative to previously published AVS analysis algorithms with lower radiation exposure compared to a full-FOV CACT.