What question did this study set out to answer?

The aim is to evaluate the effectiveness of RT-3D bSSFP MRI in visualizing the RAV confluence in primary aldosteronism compared to CECT and CV.

April 13, 2026Open Access

Respiratory triggered 3D bSSFP MRI enables accurate noninvasive localization of the right adrenal vein confluence in primary aldosteronism

Key Points

The aim is to evaluate the effectiveness of RT-3D bSSFP MRI in visualizing the RAV confluence in primary aldosteronism compared to CECT and CV.
Retrospective evaluation of patients undergoing RT-3D bSSFP, CECT, and CV between April 2016 and March 2021.
Independent assessment of RAV–IVC confluence location by two readers on each imaging modality.
Intraclass correlation coefficients and Cohen’s kappa for agreement assessment among modalities.
ICC for CECT was 0.87 and for RT-3D bSSFP was 0.81, indicating high reliability.
RT-3D bSSFP detected the common trunk with higher accuracy than CECT.
Equivalence in vertebral level was achieved between RT-3D bSSFP and CV at expiration (p = 0.0023).

Abstract

Catheterization of the right adrenal vein (RAV) is a technically challenging step in adrenal venous sampling (AVS) for primary aldosteronism. Accurate preprocedural evaluation of RAV anatomy is essential for procedural success. To assess the feasibility of respiratory-triggered three-dimensional balanced steady-state free precession (RT-3D bSSFP) magnetic resonance imaging for visualizing the confluence of the RAV with the inferior vena cava (IVC), in comparison with contrast-enhanced computed tomography (CECT). In this retrospective study, we evaluated RT-3D bSSFP, CECT, and CV for RAV identification in patients who underwent all three examinations between April 2016 and March 2021. Two independent readers evaluated the vertical level of the RAV–IVC confluence relative to the vertebrae on each modality: CECT acquired during inspiration and RT-3D bSSFP obtained under free-breathing conditions. An independent interventional radiologist assessed catheter venography (CV) during both inspiration and expiration as the reference standard. Intraclass correlation coefficients (ICC 2,1) were calculated for each modality. Additionally, the accuracy of detecting a common trunk with the accessory hepatic vein and inter-reader agreement (Cohen’s kappa) were assessed. Using CV as the reference standard and an equivalent margin of ± 0.5 vertebrae, and equivalence test was performed on CECT and RT-3D bSSFP, respectively. A total of 47 patients (38 males; mean age, 53 ± 12 years) were included. RT-3D bSSFP was successfully acquired in all cases. The ICC was 0.87 (95% confidence interval: 0.76, 0.93) for CECT and 0.81 (95% confidence interval: 0.67, 0.89) for RT-3D bSSFP. Equivalence in vertebral level was observed between RT-3D bSSFP and CV at expiration (p = 0.0023). Accuracy for detecting a common trunk was higher with RT-3D bSSFP than CECT, and inter-reader agreement was also higher (κ = 0.86 vs. 0.67). RT-3D bSSFP provides vertebral levels equivalent to CV at expiration within ± 0.5 vertebrae.

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Cite This Study

Kisohara et al. (Sat,) studied this question.

synapsesocial.com/papers/69dc88583afacbeac03ea475 https://doi.org/https://doi.org/10.1038/s41598-026-46777-3

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