Update: Selective adrenal venous sampling (AVS) – Indication, technique, and significance

Christina Loberg; Gerald Antoch; Johannes Stegbauer; Till Dringenberg; Andrea Steuwe; Günter Fürst; Matthias Haase; Lars Christian Rump; Lars Schimmöller

doi:10.1055/a-1299-1878

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Inhaltsverzeichnis

Rofo 2021; 193(06): 658-666
DOI: 10.1055/a-1299-1878

Review

Update: Selektive Nebennierenvenenblutentnahme (NNVBE) – Indikation, Technik und Stellenwert

Artikel in mehreren Sprachen: English | deutsch

Christina Loberg

¹University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany

,

Gerald Antoch

¹University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany

,

Johannes Stegbauer

²Department of Nephrology, Medical Faculty, Heinrich‐Heine‐University Düsseldorf, Düsseldorf, Germany

,

Till Dringenberg

³Division for Specific Endocrinology, University Hospital Düsseldorf, Düsseldorf, Germany

,

Andrea Steuwe

¹University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany

,

Günter Fürst

¹University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany

,

Matthias Haase

³Division for Specific Endocrinology, University Hospital Düsseldorf, Düsseldorf, Germany

,

Lars Christian Rump

²Department of Nephrology, Medical Faculty, Heinrich‐Heine‐University Düsseldorf, Düsseldorf, Germany

,

Lars Schimmöller

¹University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany

› Institutsangaben

Abstract

Zusammenfassung

Hintergrund Der primäre Hyperaldosteronismus (PHA; Conn-Syndrom) ist der häufigste nachweisbare Grund für einen sekundären arteriellen Hypertonus. Primäre Ursachen hierfür sind das Aldosteron-produzierende Adenom (APA) oder eine bilaterale adrenale Hyperplasie (BAH) mit jeweils unterschiedlicher therapeutischer Konsequenz. Weder Screening- und Funktionstests noch die Schnittbildgebung können eine unilateral dominante Hormonproduktion nachweisen.

Methode Neben einer klinischen Übersicht über Ätiologie, Diagnostik und Therapie des PHA werden in diesem Übersichtsartikel die Indikation, die Technik und der Stellenwert der selektiven Nebennierenvenenblutentnahme (NNVBE) ausführlich dargestellt und im Kontext aktueller Literatur diskutiert.

Ergebnisse Die NNVBE kann mit hoher Erfolgsrate eine unilaterale Dominanz nachweisen oder ausschließen. Patienten mit PHA und unilateralem APA können kurativ durch eine Adrenalektomie behandelt werden.

Schlussfolgerung Die NNVBE ist eine etablierte Intervention zur Subtypisierung des PHA in eine unilaterale oder bilaterale Erkrankung der Nebenniere.

Kernaussagen:

Die Nebennierenvenenblutentnahme (NNVBE) ist eine sichere, zuverlässige und minimalinvasive Methode zur Detektion einer unilateralen oder bilateralen Erkrankung der Nebenniere.
Der Nachweis einer Lateralisierung durch die NNVBE hat eine unmittelbare Relevanz für die kurative Therapie des primären Hyperaldosteronismus (PHA).
Die NNVBE kann mit hoher Treffer- und Erfolgsrate ohne Kontrastmittelgabe und mit geringer Strahlenexposition in der Hand eines erfahrenen Untersuchers durchgeführt werden.

Zitierweise

Loberg C, Antoch G, Stegbauer J et al. Update: Selective adrenal venous sampling (AVS) – Indication, technique, and significance. Fortschr Röntgenstr 2021; 193: 658 – 666

Key words

adrenal gland - interventional procedures - angiography - blood - hypertension

Volltext

Referenzen

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