대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제84권2호
  • /
  • Pages.386-397
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  • 2023
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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일차성고알도스테론혈증에서의 부신정맥채혈술: 최적의 좌측채혈을 위한 임상화보

Adrenal Vein Sampling in Primary Aldosteronism: A Pictorial Essay for Optimal Left-Side Sampling

  • 김기주 (성균관대학교 의과대학 강북삼성병원 영상의학과) ;
  • 김명섭 (성균관대학교 의과대학 강북삼성병원 영상의학과) ;
  • 홍현표 (성균관대학교 의과대학 강북삼성병원 영상의학과) ;
  • 이영래 (성균관대학교 의과대학 강북삼성병원 영상의학과) ;
  • 최연규 (성균관대학교 의과대학 강북삼성병원 영상의학과)
  • Gi Joo Kim (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Myung Sub Kim (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Hyun Pyo Hong (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Young Rae Lee (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Yeon Gyu Choi (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2021.12.08
  • 심사 : 2022.08.07
  • 발행 : 2023.03.01
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초록

일차성고알도스테론혈증은 고혈압의 원인 중 높은 비중을 차지하는 질병이다. 부신정맥채혈술은 일차성고알도스테론혈증의 원인을 감별하여 최종적인 치료방침을 결정하는 데 있어 필수적인 검사이다. 부신정맥채혈술의 성공 여부는 각 부신정맥에서 채혈한 샘플의 혈중 코티솔 농도와 말초혈관에서 채혈한 샘플의 혈중 코티솔 농도의 비를 측정하여 판단한다. 하대정맥으로 바로 연결되는 오른부신정맥에서 시술의 실패율이 더 높게 보고되며 상대적으로 왼부신정맥의 시술 실패율은 낮지만 드물게 보고된다. 본 임상화보에서는 왼부신정맥 부신정맥채혈술의 실패 사례를 소개하고 분석하여 최적의 부신정맥채혈술을 위한 고려사항에 대해 고찰하고자 한다.

Primary aldosteronism (PA) is a curable cause of hypertension. Recent studies have revealed that the actual prevalence of PA is higher than previously recognized. Adrenal vein sampling (AVS) is an essential diagnostic procedure for revealing the cause of PA and determining the treatment plan. The success of AVS is confirmed by comparing cortisol levels between the samples from each adrenal vein and peripheral vein. The failure rate of the procedure is reported to be high in the right adrenal vein, which is directly connected to the inferior vena cava, while that in the left adrenal vein is relatively low; however, this has rarely been reported. In this review, we introduce and analyze cases of failure in left adrenal vein sampling.

키워드

참고문헌

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