Imaging Analysis During Adrenal Venous Sampling Operations

Abstract Background To investigate the imaging anatomy and variations of bilateral adrenal veins to improve the success rate during adrenal venous sampling (AVS) and reduce the incidence of complications. Methods A total of 120 patients who underwent AVS from June 2017 to January 2019 were collected. RadiAnt Viewer software was used to retrospectively analyze the intraoperative imaging data, intraoperative anatomical variation data, the success rate, and complications of AVS. Results The ostium of the right adrenal vein was located mainly between the lower 1/3 of the 11th thoracic vertebra and the middle 1/3 of the 12th thoracic vertebra, accounting for 75.5% of the cases. Most of the ostium (83.3%) was transversely distributed between 9 o’clock and 12 o’clock. The main morphology of the right adrenal venography was a triangular pattern (48.2%). As the body mass index increased, the ostium was higher, and the distance between the ostium and the spine was greater (P < 0.05). The success rate of the right AVS, the left AVS, and the bilateral AVS was 95.0%, 97.5%, and 92.5%, respectively. The anatomical variation rate of the right adrenal vein was 5.3%. All cases showed that the right adrenal vein entered the accessory right hepatic vein and then into the inferior vena cava. The anatomical variation rate of the left adrenal vein was 4.3%. Conclusions Body mass index can be used to predict the location of the right adrenal vein ostium. Understanding of the anatomy and variation of the adrenal vein and right adrenal venography is essential to a successful AVS.