Abstract 5531: The Impacts of Thin-Slice Contrast-Enhanced Computed Tomography and Rapid Cortisol Measurement During Adrenal Venous Sampling

Abstract

Background: It has been considered that Adrenal venous sampling (AVS) is the golden standard to identify primary aldosteronism (PA). However, there have been technical difficulties in AVS, especially in right AVS. Therefore, we investigated whether the anatomical examination of adrenal vein using thin-slice contrast-enhanced computed tomography (CT) and the monitoring cortisol concentrations during catheterization affect the success rate of AVS in patients with suspected of having PA. Methods: Forty-eight patients who were suspected of having PA, were enrolled. Thin-slice contrast-enhanced CT with 1.2mm-slice and rapid cortisol assay using electro chemiluminescent Immunoassay (ECLIA) were performed in 18 patients (Group I). Contrast-enhanced CT with 5mm-slice were performed in 20 patients (Group II). Samples were collected from the vena cava as well as from right and left adrenal veins. We evaluated the procedure success rate and the total radiation time in two groups. Results: Date are expressed as the mean±SEM. The patients characteristics were similar in the two groups. On contrast-enhanced CT, right adrenal vein was detected in all patients in Group I (100%) although it was detected only 11 patients (55%) in Group II (p<0.05). The success rate of AVS was significant higher in Group I (96%), than in Group II (30%, p<0.0001) while the success rate of left AVS was not different in the two groups. The total radiation time was shorter in Group I (22±8 min) than Group II (32±9 min, p<0.05). Conclusions: Anatomical examination using thin-slice contrast-enhanced CT and intraoperative cortisol assays increase the procedure success rate, and decrease the duration time of radiation. The rapid cortisol assay kit might be valuable and timely information for improving the success rate of adrenal venous sampling. This research has received full or partial funding support from the American Heart Association, National Center.