肾上腺静脉取血判断双侧肾上腺结节背景下 左侧腺醛固酮瘤1例

Left Aldosterone-Producing Adenoma Identified by Adrenal Venous Sampling in a Patient with Bilateral Adrenal Nodules: A Case Report

摘要: 目的：探讨肾上腺静脉取血对影像表现为双侧肾上腺结节的原发性醛固酮增多症的诊疗指导。方法：回顾性分析1例双侧肾上腺占位的原发性醛固酮增多症患者的诊疗经过。结果：肾上腺静脉取血结果提示左侧分泌优势的原发性醛固酮增多症，行腹腔镜下左肾上腺腺瘤切除术，术后病理证实左侧肾上腺皮质腺瘤，螺内酯单药降压治疗后得到生化与临床缓解。结论：对于双侧肾上腺结节的原醛症患者，单侧取血失败后的综合结果判读可以帮助建立更精细化决策流程，为临床医师提供了在复杂决策路径中的选择。

Abstract: Objective: To explore the clinical value of adrenal venous sampling (AVS) in guiding the diagnosis and treatment of primary aldosteronism (PA) in patients with bilateral adrenal nodules on imaging. Methods: A retrospective analysis was conducted on the diagnostic and therapeutic process of a patient with primary aldosteronism presenting with bilateral adrenal masses. Results: Adrenal venous sampling indicated left-sided aldosterone hypersecretion dominance. The patient subsequently underwent laparoscopic left adrenalectomy. Postoperative pathological examination confirmed a left adrenal cortical adenoma. Following surgery, the patient achieved both biochemical and clinical remission with spironolactone monotherapy for blood pressure control. Conclusion: For patients with primary aldosteronism and bilateral adrenal nodules, the interpretation of adrenal venous sampling results plays a crucial role in clinical decision-making and is of great significance for accurate diagnosis and appropriate treatment.