An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult
Catheterization of the right adrenal vein (rt.AdV) to obtain blood samples can often be difficult. The aim of the present study was to investigate whether blood sampling from the inferior vena cava (IVC) at its juncture with the rt.AdV can be an ancillary to sampling of blood directly from the rt.Ad...
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MDPI AG
2023-02-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/4/649 |
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| author | Akira Yamamoto Takeshi Fukunaga Mitsuru Takeuchi Hiroki Nakamura Akihiko Kanki Atsushi Higaki Tsutomu Tamada |
| author_facet | Akira Yamamoto Takeshi Fukunaga Mitsuru Takeuchi Hiroki Nakamura Akihiko Kanki Atsushi Higaki Tsutomu Tamada |
| author_sort | Akira Yamamoto |
| collection | DOAJ |
| description | Catheterization of the right adrenal vein (rt.AdV) to obtain blood samples can often be difficult. The aim of the present study was to investigate whether blood sampling from the inferior vena cava (IVC) at its juncture with the rt.AdV can be an ancillary to sampling of blood directly from the rt.AdV. This study included 44 patients diagnosed with primary aldosteronism (PA) in whom AVS with adrenocorticotropic hormone (ACTH) was performed, resulting in a diagnosis of idiopathic hyperaldosteronism (IHA) (<i>n</i> = 24), and patients diagnosed with unilateral aldosterone-producing adenoma (APA) (<i>n</i> = 20; rt.APA = 8, lt.APA = 12). In addition to regular blood sampling, blood was also sampled from the IVC, as the substitute rt.AdV [S-rt.AdV]. Diagnostic performance with the conventional lateralized index (LI) and the modified LI using the S-rt.AdV were compared to examine the utility of the modified LI. The modified LI of the rt.APA (0.4 ± 0.4) was significantly lower than those of the IHA (1.4 ± 0.7) (<i>p</i> < 0.001) and the lt.APA (3.5 ± 2.0) (<i>p</i> < 0.001). The modified LI of the lt.APA was significantly higher than those of the IHA (<i>p</i> < 0.001) and rt.APA (<i>p</i> < 0.001). Likelihood ratios to diagnose rt.APA and lt.APA using the modified LI with threshold values of 0.3 and 3.1 were 27.0, and 18.6, respectively. The modified LI has the potential to be an ancillary method for rt.AdV sampling in cases in which rt.AdV sampling is difficult. Obtaining the modified LI is extremely simple, which might complement conventional AVS. |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T08:56:54Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-5630795555e448859287a7f47e88733c2023-11-16T20:01:00ZengMDPI AGDiagnostics2075-44182023-02-0113464910.3390/diagnostics13040649An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is DifficultAkira Yamamoto0Takeshi Fukunaga1Mitsuru Takeuchi2Hiroki Nakamura3Akihiko Kanki4Atsushi Higaki5Tsutomu Tamada6Department of Radiology, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Radiology, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Radiology, Radiolonet Tokai, Nagoya 460-8501, JapanDepartment of Radiology, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Radiology, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Radiology, Kawasaki Medical School, Kurashiki 701-0192, JapanDepartment of Radiology, Kawasaki Medical School, Kurashiki 701-0192, JapanCatheterization of the right adrenal vein (rt.AdV) to obtain blood samples can often be difficult. The aim of the present study was to investigate whether blood sampling from the inferior vena cava (IVC) at its juncture with the rt.AdV can be an ancillary to sampling of blood directly from the rt.AdV. This study included 44 patients diagnosed with primary aldosteronism (PA) in whom AVS with adrenocorticotropic hormone (ACTH) was performed, resulting in a diagnosis of idiopathic hyperaldosteronism (IHA) (<i>n</i> = 24), and patients diagnosed with unilateral aldosterone-producing adenoma (APA) (<i>n</i> = 20; rt.APA = 8, lt.APA = 12). In addition to regular blood sampling, blood was also sampled from the IVC, as the substitute rt.AdV [S-rt.AdV]. Diagnostic performance with the conventional lateralized index (LI) and the modified LI using the S-rt.AdV were compared to examine the utility of the modified LI. The modified LI of the rt.APA (0.4 ± 0.4) was significantly lower than those of the IHA (1.4 ± 0.7) (<i>p</i> < 0.001) and the lt.APA (3.5 ± 2.0) (<i>p</i> < 0.001). The modified LI of the lt.APA was significantly higher than those of the IHA (<i>p</i> < 0.001) and rt.APA (<i>p</i> < 0.001). Likelihood ratios to diagnose rt.APA and lt.APA using the modified LI with threshold values of 0.3 and 3.1 were 27.0, and 18.6, respectively. The modified LI has the potential to be an ancillary method for rt.AdV sampling in cases in which rt.AdV sampling is difficult. Obtaining the modified LI is extremely simple, which might complement conventional AVS.https://www.mdpi.com/2075-4418/13/4/649adrenal venous samplingalternative methodslaterality indexmodified laterality index |
| spellingShingle | Akira Yamamoto Takeshi Fukunaga Mitsuru Takeuchi Hiroki Nakamura Akihiko Kanki Atsushi Higaki Tsutomu Tamada An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult Diagnostics adrenal venous sampling alternative methods laterality index modified laterality index |
| title | An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult |
| title_full | An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult |
| title_fullStr | An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult |
| title_full_unstemmed | An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult |
| title_short | An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult |
| title_sort | ancillary method for adrenal venous sampling in cases in which right adrenal vein sampling is difficult |
| topic | adrenal venous sampling alternative methods laterality index modified laterality index |
| url | https://www.mdpi.com/2075-4418/13/4/649 |
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