Anatomical Variations of the Right Adrenal Vein: Concordance between Multidetector Computed Tomography and Catheter Venography
2017
Adrenalvenous sampling is the most reliable diagnostic procedure to determine surgical indications in
primary aldosteronism. Because guidelines recommend multidetector computed tomography (CT) to evaluate the
adrenalgland, some past reports used multidetector CT as a guide for
adrenalvenous sampling. However, the detailed anatomy of the right
adrenal
veinand its relationship with an accessory
hepatic veinremains uncertain. The purpose of this study was to describe detailed anatomical variations of the right
adrenal
veinand to determine the concordance between CT and catheter
venographyin patients with
primary aldosteronism. In total, 440 consecutive patients who underwent
adrenalvenous sampling were included. Four-phase dynamic CT was performed. Anatomical locations and variations of the right
adrenal
veinand its relationship with the accessory
hepatic veinwere compared with catheter venographic findings. Successful catheterization was achieved in 437 patients (99%). The right
adrenal
veinwas visualized in the late arterial phase with CT in 420 patients (95%). The right
adrenal
veinformed a common trunk with the accessory
hepatic veinin 87 patients (20%). CT identified the correct craniocaudal level of the orifice in 354 patients (84%). Anatomical variations, location, and angle of inflow of the right
adrenal
veinbased on CT demonstrated high concordance with catheter
venography. CT may provide useful information for preparation before
adrenalvenous sampling.
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