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上腺静脉样本采集的内部协议 在初级阿尔多斯特罗尼斯的不一致性 侧面化
Livia M Mermejo1,2, Lili Zhao3, Chaelin Lee1
1Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, 1150 W Medical Center Dr, MSRB II, 5570B, Ann Arbor, MI 48109.
Radiology
|April 15, 2025
概括
在接受上腺静脉采样 (AVS) 的患者中,近三分之一的患者在相同的协议中显示出不一致的横向化结果. 这种变异性对于初级阿尔多斯特隆症诊断至关重要,在基线样本中,与用可辛热素刺激的样本相比,这种变异性更高.
科学领域:
- 内分泌学 在内分泌学.
- 放射学 放射学是一门学科.
- 内部医学 内部医学
背景情况:
- 主要阿尔多斯特主义 (PA) 诊断依赖于上腺静脉采样 (AVS) 来识别横向化.
- 当前的AVS协议可能具有影响横向化结果的协议内变异性.
- 了解这种变异性是准确的PA亚型和外科候选人的关键.
研究的目的:
- 在同时进行AVS时量化协议内侧面化不一致性.
- 为了比较基线和辅热素刺激的AVS测量之间的变异性.
主要方法:
- 对402名同时接受AVS的PA患者进行了回顾性分析.
- 分析了六个样本组 (三个基线,三个后可辛热素刺激).
- 横向化指数 (LI) ≥4定义为横向化PA;在三重复样本中评估的不一致性.
主要成果:
- 32.1%的患者表现出至少一个侧面化不一致.
- 在基线 (22.1%) 中,不一致性比刺激 (13.2%) AVS 组更频繁.
- 在基线样本和上腺静脉中观察到的最高变异性,具有较低的阿尔多素输出.
结论:
- 在AVS横向化结果中存在显著的协议内变异性.
- 基线AVS测量显示出比用cosyntropin刺激的测量更高的不一致性.
- 这些发现突出了AVS解释的潜在挑战和协议优化需求.
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