Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CT
PURPOSEWe aimed to assess the value of adrenal venous sampling (AVS) for diagnosing primary aldosteronism (PA) subtypes in patients with a unilateral nodule detected on adrenal computed tomography (CT) and scheduled for adrenalectomy. MATERIALS AND METHODSThis retrospective study included 80 consecu...
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2014-01-01
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| Series: | Diagnostic and Interventional Radiology |
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http://www.dirjournal.org/archives/archive-detail/article-preview/adrenal-venous-sampling-for-stratifying-patients-f/56404
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| _version_ | 1797691433523609600 |
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| author | Jin Young Kim See Hyung Kim Hee Jung Lee Young Hwan Kim Mi Jeong Kim Seung Hyun Cho |
| author_facet | Jin Young Kim See Hyung Kim Hee Jung Lee Young Hwan Kim Mi Jeong Kim Seung Hyun Cho |
| author_sort | Jin Young Kim |
| collection | DOAJ |
| description | PURPOSEWe aimed to assess the value of adrenal venous sampling (AVS) for diagnosing primary aldosteronism (PA) subtypes in patients with a unilateral nodule detected on adrenal computed tomography (CT) and scheduled for adrenalectomy. MATERIALS AND METHODSThis retrospective study included 80 consecutive patients with PA undergoing CT and AVS. Different lateralization indices were assessed, and a cutoff established using receiver operating characteristic curve analysis. The value of CT alone versus CT with AVS for differentiating PA subtypes was compared. The adrenalectomy outcome was assessed, and predictors of cure were determined using univariate analysis. RESULTSAVS was successful in 68 patients. A cortisol-corrected aldosterone affected-to-unaffected ratio cutoff of 2.0 and affected-to-inferior vena cava ratio cutoff of 1.4 were the best lateralization indices, with accuracies of 82.5% and 80.4%, respectively. CT and AVS diagnosed 38 patients with aldosterone-producing adenomas, five patients with unilateral adrenal hyperplasia, and 25 patients with bilateral adrenal hyperplasia. Of the 52 patients with a nodule detected on CT, subsequent AVS diagnosed bilateral adrenal hyperplasia in 14 patients (27%). Compared to the results of combining CT with AVS, the accuracy of CT alone for diagnosing aldosterone-producing adenomas was 71.1% (P < 0.001). The cure rate for hypertension after adrenalectomy was 39.2%, with improvement in 53.5% of patients. On univariate analysis, predictors of persistent hypertension were male gender and preoperative systolic blood pressure. CONCLUSIONTo avoid inappropriate surgery, AVS is necessary for diagnosing unilateral nodules with aldosterone hypersecretion detected by CT. |
| first_indexed | 2024-03-12T02:14:15Z |
| format | Article |
| id | doaj.art-85262274b3634835a16ae2d3252850d6 |
| institution | Directory Open Access Journal |
| issn | 1305-3825 1305-3612 |
| language | English |
| last_indexed | 2024-03-12T02:14:15Z |
| publishDate | 2014-01-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Diagnostic and Interventional Radiology |
| spelling | doaj.art-85262274b3634835a16ae2d3252850d62023-09-06T11:15:36ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122014-01-01201657110.5152/dir.2013.1314413049054Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CTJin Young Kim0See Hyung Kim1Hee Jung Lee2Young Hwan Kim3Mi Jeong Kim4Seung Hyun Cho5 Department of Radiology Dongsan Hospital, Keimyung University College of Medicine Department of Radiology Dongsan Hospital, Keimyung University College of Medicine, Daegu Department of Radiology Dongsan Hospital, Keimyung University College of Medicine, Daegu Department of Radiology Dongsan Hospital, Keimyung University College of Medicine, Daegu Department of Radiology Dongsan Hospital, Keimyung University College of Medicine, Daegu Department of Radiology Kyungpook National University School of Medicine, Daegu, Republic of Korea. PURPOSEWe aimed to assess the value of adrenal venous sampling (AVS) for diagnosing primary aldosteronism (PA) subtypes in patients with a unilateral nodule detected on adrenal computed tomography (CT) and scheduled for adrenalectomy. MATERIALS AND METHODSThis retrospective study included 80 consecutive patients with PA undergoing CT and AVS. Different lateralization indices were assessed, and a cutoff established using receiver operating characteristic curve analysis. The value of CT alone versus CT with AVS for differentiating PA subtypes was compared. The adrenalectomy outcome was assessed, and predictors of cure were determined using univariate analysis. RESULTSAVS was successful in 68 patients. A cortisol-corrected aldosterone affected-to-unaffected ratio cutoff of 2.0 and affected-to-inferior vena cava ratio cutoff of 1.4 were the best lateralization indices, with accuracies of 82.5% and 80.4%, respectively. CT and AVS diagnosed 38 patients with aldosterone-producing adenomas, five patients with unilateral adrenal hyperplasia, and 25 patients with bilateral adrenal hyperplasia. Of the 52 patients with a nodule detected on CT, subsequent AVS diagnosed bilateral adrenal hyperplasia in 14 patients (27%). Compared to the results of combining CT with AVS, the accuracy of CT alone for diagnosing aldosterone-producing adenomas was 71.1% (P < 0.001). The cure rate for hypertension after adrenalectomy was 39.2%, with improvement in 53.5% of patients. On univariate analysis, predictors of persistent hypertension were male gender and preoperative systolic blood pressure. CONCLUSIONTo avoid inappropriate surgery, AVS is necessary for diagnosing unilateral nodules with aldosterone hypersecretion detected by CT. http://www.dirjournal.org/archives/archive-detail/article-preview/adrenal-venous-sampling-for-stratifying-patients-f/56404 |
| spellingShingle | Jin Young Kim See Hyung Kim Hee Jung Lee Young Hwan Kim Mi Jeong Kim Seung Hyun Cho Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CT Diagnostic and Interventional Radiology |
| title | Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CT |
| title_full | Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CT |
| title_fullStr | Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CT |
| title_full_unstemmed | Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CT |
| title_short | Adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced CT |
| title_sort | adrenal venous sampling for stratifying patients for surgery of adrenal nodules detected using dynamic contrast enhanced ct |
| url |
http://www.dirjournal.org/archives/archive-detail/article-preview/adrenal-venous-sampling-for-stratifying-patients-f/56404
|
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