Diagnostic value of adrenal CT combined with serum potassium and serum aldosterone in the classification diagnosis of primary aldosteronism

MA Xiao-kun; QIN Gui-jun; JI Hong-fei; WANG Hai-bin; ZHAO Lin

doi:10.19538/j.nk2024110110

Abstract：Objective To study the role of adrenal CT,serum potassium and aldosterone in the classified diagnosis of PA.Methods A total of 113 patients with PA were enrolled,who completed AVS examination in the First Affiliated Hospital of Zhengzhou University from August 2020 to March 2022.Patients with unilateral lesions on CT(n=74)were divided into the inconsistent CT and AVS group(n=33)and the consistent CT and AVS group(n=41).The differences in serum potassium and PAC between the two groups were studied.The logistic regression analysis was used to investigate the predictors of consistency between CT and AVS.ROC curve was used to evaluate the predictive value of serum potassium and post-SIT PAC for the consistency of CT and AVS.Results Compared with the inconsistent AVS group,the consistent AVS group had younger age,lower serum potassium,higher PAC(whatever at random site or post-SIT)and higher ARR.The logistic regression analysis showed that serum potassium(OR 0.111,95％CI 0.018-0.692,P=0.018)and post-SIT PAC(OR 1.008,95％CI 1.001-1.015,P=0.021)were independent predictors of consistency between CT and AVS.ROC curve analysis showed that the optimal cut-off point of serum potassium was 3.1 mmol/L(AUROC 0.835,sensitivity 0.788,specificity 0.805,P=0.000).The optimal cut-off point of post-SIT PAC was 20.00 ng/dL(AUROC 0.882,sensitivity 0.882,specificity 0.844,P=0.000).The optimal cut-off point of age was 46 years old(AUROC 0.638,sensitivity 0.758,specificity 0.561,P=0.043).Conclusion In patients with unilateral lesions shown on CT,if blood potassium is less than 3.1 mmol/L and post-SIT PAC is greater than 20 ng/dL,the unilateral PA is possible.