Why adrenal venous sampling is indispensable in the management of primary aldosteronism patients How to visualize and evaluate adrenal veins by MDCT Technical tips, pitfalls, and anatomical variation of the adrenal veins nesessaryto achieve high success rate of adrenal venous sampling Typical imagesof adrenal venous sampling

Prevalence rate of primary aldosteronism Primary aldosteronism is increasingly recognized as a cause of secondary hypertension with prevalence rate of approximately 10% in hypertensive populations. Why adrenal venous sampling is indispensable in the management of primary aldosteronism patients Management of primary aldosteronism It is critically important to distinguish unilateral aldosterone producing adenoma from bilateral idiopathic adrenal hyperplasia because unilateral hypersecretion of aldosterone can be treated surgically. CT is not reliable in subtype diagnosis of primary aldosteronism Morphological diagnosis by MDCT is not reliable in diagnosing...

Capability of MDCT to detect adrenal vein: MDCT precisely detects the right adrenal venous location and course with information of accessory hepatic veins. MDCT protocol: Anatomical types of the right adrenal vein and newly developed catheters for right adrenal venous sampling We classified right adrenal venous anatomy into 5 types (upward type, downward type, medial insertion type, medial direction type, and common trunk with accessory hepatic vein),developing 5 types of catheters (Adselect series, Hanako Medical, Tokyo, Japan) suitable for each anatomy. Adrenal venous sampling using...

Primary aldosteronism is increasingly recognized as a cause of secondary hypertension. Its prevalence in hypertensive populations is estimated at approximately 10%. Unilateral aldosterone hypersecretion caused by unilateral aldosterone producing adenoma is a curable form of hypertension. Although selective adrenal venous sampling is a difficult procedure, high success rate of adrenal venous sampling can be achieved by MDCT anatomical information, whichleads to adequate management of hypertension patients.

Kei Takase, MD, PhD, Department of Diagnostic Radiology, Tohoku University School of Medicine 1-1, Seiryo, Aoba-ku, Sendai, Miyagi, Japan 980-8574 e-mail: [email protected]

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