What is the role of selective venous sampling in the diagnosis of pheochromocytoma?

Updated: Aug 10, 2018
  • Author: Michael A Blake, MBBCh, MRCPI, FRCR; Chief Editor: George T Griffing, MD  more...
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Answer

Because of the high sensitivity of MRI and CT scanning, procedures are rarely indicated for localization of pheochromocytomas. Selective venous sampling is seldom performed to localize pheochromocytomas but has occasionally been used to detect extra-adrenal pheochromocytomas that were not found at surgery.

In most cases, this procedure is not helpful in detecting extra-adrenal tumors, because catecholamine levels have marked variability. An exception to this rule, however, occurs if the norepinephrine concentration is greater than the epinephrine concentration in the venous effluent. Because the primary catecholamine produced and stored in the adrenal gland is epinephrine, a ratio of norepinephrine to epinephrine that is greater than 1 suggests a pheochromocytoma.


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