Recognizing the Right Adrenal Vein

Adrenal vein sampling failure is most commonly caused by inadequate sampling of the right adrenal vein (RAV). To be successful in sampling from the RAV, one must be able to recognize its venographic appearance as well as the distinguishing features of its mimics. Multiple clues such as location, branching pattern, and the presence of emissary veins are used to distinguish the two. Cone beam CT (CB-CT) can be a valuable tool for ambiguous cases. By providing an image-rich review, this paper should help readers discriminate the RAV from potential mimics.