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左上腺静脉采样地点之间的差异,在初级阿尔多斯龙主义的细分采样中被揭示出来
Hiromitsu Tannai1,2, Kohzoh Makita3, Kazuki Nakai4
1Department of Radiology, Yokohama Rosai Hospital, Yokohama, Japan.
The British journal of radiology
|September 3, 2023
概括
左上腺中心静脉 (LCV) 采样在一次性阿尔多斯特隆症中对上腺静脉采样 (AVS) 更成功,而不是共同干 (CMT) 部位. 液体CV采样减少了AVS失效率,有助于准确的诊断.
科学领域:
- 内分泌学 在内分泌学.
- 干预性放射学 干预性放射学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 主要的阿尔多斯特主义诊断依赖于上腺静脉采样 (AVS).
- 精确的阿尔多激素过度产生的横向化对于治疗决策至关重要.
- 对比左上腺中央静脉 (LCV) 和普通干 (CMT) 采样地点对于优化AVS成功很重要.
研究的目的:
- 为了比较LCV和CMT采样地点对上腺静脉采样 (AVS) 的疗效.
- 分析这些采样地点对诊断原发性阿尔多斯特主义亚型的影响.
- 评估LCV和CMT采样之间的成功率和诊断一致性.
主要方法:
- 从2017年到2020年,对432名接受了共热素刺激的细分AVS (sAVS) 的患者进行了回顾性分析.
- 在LCV和CMT采样之间比较激素水平 (阿尔多斯特,皮质醇) 和选择性指数 (SI).
- 基于横向化指数 (LI) 和sAVS的亚型诊断,不包括SI<3的病例.
主要成果:
- 与LCV采样相比,CMT采样显示阿尔多和皮质醇水平显著降低,SI<3和<5的病例比例更高.
- 在两个采样地点之间,阿尔多与皮质醇的比率和LI并没有显著差异.
- LCV和CMT采样之间的诊断一致性很高 (94.7%),基于sAVS诊断的一致率没有显著差异.
结论:
- 与CMT采样相比,LCV采样更频繁地满足成功AVS的SI标准.
- 在满足标准的情况下,没有一个采样地点在诊断准确性方面表现出优越性.
- 液动心血管采样与AVS失效率的降低有关.
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