Anatomical Variations of the Right Adrenal VeinNovelty and Significance: Concordance Between Multidetector Computed Tomography and Catheter Venography

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. # Novelty and Significance {#article-title-28}