A Comparative Study Of Right Adrenal Venous Sampling With And Without3-dimensional Reconstruction

Objective:Adrenal venous sampling(AVS) is recommended as the goldstandard procedure for subtype classification in PA, but the procedureis challenging and the right adrenal vein (RAV) particularly difficultto cannulate because it is short, variable and enters the inferior venacava (IVC) at an acute angle. Our purpose was to find a feasible methodin right adrenal venous cannulation by using MDCT with three dimensionalreconstruction before AVS.Subjects and Methods: From August2013to April2014, a total of21patients with confirmed PA who had a unilateral or bilateral adrenalmorphology abnormalities (includingHyperplasia or adenoma whichdiameter<1cm)underwent AVS were analyzed retrospectively.8of thepatients used MDCT with3-dimensional before AVS, the other13patientswithout using MDCT with3-dimensional before AVS served as controls. Tocompare the rate of correct cannulation,contrast volume used, and timeof right adrenal venous sampling between two groups above. Successfuladrenal vein catheterizationis defined by a ratio of>3:1of cortisol inthe adrenal vein vs. the inferior vena cava.Results: As compared to controls, using MDCT with three dimensionalreconstruction before AVS increased the rate of correct cannulation intoRAV from23.1%to87.5%(p=0.008), decreased the contrast volume about40%（50±22.4mL Vs.30±15.1mL，P=0.038）and shortened the time toidentify RAV by45%（26±11.1min Vs.14±7.9min，p=0.020）.Conclusion：MDCT with3-dimensional reconstruction used before AVS mightprovide visual confirmation of correct cannulation, decrease the contrastvolume, shorten the time to identify RAV, and improve success rates of RAV sampling.