A STUDY ON THE CONSISTENCY OF ADRENAL VENOUS SAMPLING (AVS) AND COMPUTED TOMOGRAPHY (CT) IN THE SUBTYPE DIAGNOSIS OF PRIMARY ALDOSTERONISM (PA)

Objective: To investigate the consistency between adrenal venous sampling (AVS) and computed tomography (CT) in subtype diagnosis of patients with primary aldosteronism (PA). Design and method: A total of 560 PA patients who underwent AVS in our hospital from January 2017 to December 2024 were selected. Based on CT results, patients with unilateral lesions (n=312) were divided into a CT-AVS consistent group (n=175) and a CT-AVS inconsistent group (n=137). Among them, there were 166 males and 146 females, with a median age of 49 years. Further stratification by age divided patients into a young group (31 patients, <35 years old) and a middle-aged and elderly group (281 patients, more than 35 years old), with the latter further subdivided into Group A (35-50 years old), Group B (50-65 years old), and Group C (65-80 years old). Statistical methods were used to analyze differences between groups. The diagnostic value of CT and AVS in preoperative assessment of primary aldosteronism (PA) patients was analyzed, and the consistency of different methods in subtype diagnosis among PA patients of different age groups was explored. Results: The median age of the consistent group was 47 years, lower than the 53 years in the inconsistent group. In the young group, the consistency rate between CT and AVS in subtype diagnosis was 74.19% (23/31), significantly higher than the 53.74% (151/281) in the middle-aged and elderly group, with a statistical difference between the two groups (chi-square=4.737, P=0.03). In Groups A, B, and C, the consistency rates between CT and AVS were 60.72% (79/128), 47.86% (56/117), and 36.11% (13/36), respectively, all lower than that in the young group. With increasing age, the consistency between CT and AVS showed a downward trend. Conclusions: In the subtype diagnosis of primary aldosteronism, adrenal venous sampling (AVS) has higher diagnostic value compared to computed tomography (CT). Regardless of age, for PA patients with unilateral lesions shown on CT, AVS should be considered as the first-choice diagnostic method. This helps to more accurately determine the side of the lesion, guide surgical treatment, and improve patient prognosis.