Usefulness of respiratory-triggered 3D-balanced steady-state free precession in assessing the anatomy of the right adrenal vein for adrenal vein sampling

Abstract

Abstract Background Primary aldosteronism (PA) is one of the causes of hypertension. Adrenal vein sampling (AVS) is an interventional radiology procedure used to devise therapeutic strategies for PA. Since catheterization of the right adrenal vein (RAV) is a difficult step in AVS, evaluation of the anatomy of the RAV is essential before AVS. Purpose We assessed the confluence of the RAV with the inferior vena cava (IVC) with respiratory-triggered 3D-balanced steady-state free precession magnetic resonance imaging (RT-3D bSSFP) and dynamic contrast-enhanced computed tomography (CECT). Materials and Methods Those with RAVs identifiable on RT-3D bSSFP and CECT were included. We evaluated the vertebral level of the confluence of the RAV with the IVC on RT-3D bSSFP and CECT over 10 even divisions of the adjacent intervertebral discs. We also evaluated the highest and lowest levels of the confluence of the RAV with the IVC during AVS procedures on digital angiography to test equivalence. Results The confluence of the RAV with the IVC was identified in all modalities in 39 patients which met the inclusion criteria. 95% confidential intervals of the differences in mean showed − 1.00–0.48, -0.01-0.56, -0.21-0.36, -0.71–0.21, and − 0.90–0.41 between RT-3D bSSFP and CECT, RT-3D bSSFP and angiography during spontaneous inspiration (inspiration), RT-3D bSSFP and angiography during spontaneous expiration (expiration), CECT and inspiration, and CECT and expiration, respectively. Equivalence in height was observed between RT-3D bSSFP and expiration (p = 0.0023). Conclusion RT-3D bSSFP is helpful in evaluating the height at which the RAV merges into the IVC.