Objective To discuss the feasibility and safety of simultaneous bilateral adrenal vein sampling(AVS)using two 4F-MPA1 catheters via right elbow vein access.Methods A total of 51 consecutive patients with primary aldosteronism,who received simultaneous bilateral AVS using two 4F-MPA1 catheters(one of the two catheters was shaped into pig tail figure)via right elbow vein access at Xiangyang Municipal Central Hospital between October 2021 and October 2022,were enrolled in this study.The used catheter,the success rate of simultaneous bilateral AVS,and the incidence of complications rate were calculated.Results The 4F-MPA1 catheter was used for all of the right AVS,while a specially shaped 4F-MPA1 catheter was used for the main trunk vein AVS of the left adrenal gland and the central vein AVS of the left adrenal gland.The success rate of simultaneous bilateral AVS was 92.2%(47/51).Adrenal hematoma occurred in one patient(1.96%).Conclusion The technique of simultaneous bilateral AVS using two 4F-MPA1 catheters via right elbow vein access is simple to operate,less traumatic,and clinically safe and feasible.However,due to the small sample used in this study,the clinical value of this technique still needs further investigation and verification.

Purpose To observe the changes in the brain microstructure of children with global developmental delay(GDD)via MR diffusion kurtosis imaging(DKI).Materials and Methods A total of 34 children with GDD were included as the experimental group,and 34 children with normal development as the control group in the Third Affiliated Hospital of Zhengzhou University from September 2020 to March 2023,retrospectively.DKI and clinical data were collected.After post-processing,DKI parameters were obtained,including fraction anisotropy,mean kurtosis(MK),axial kurtosis and radial kurtosis(Kr).The differences in parameters in each region of interest of the two groups were analyzed,the correlation between DKI parameters and Gesell developmental scale was analyzed,and the receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of DKI parameters.Results Compared with the control group,the MK value of the centrum semiovale decreased(Z=-2.723,P<0.01),the MK value and Kr value of the thalamus decreased(t/Z=-3.220,-3.128,both P<0.01),the MK value and axial kurtosis value of the anterior and posterior limb of internal capsule decreased(t/Z=-2.958,-2.573,-2.085,-2.403,all P<0.05),the Kr value of the anterior limb of internal capsule decreased(t=-2.155,P<0.05),the MK value and Kr value of frontal white matter decreased(Z=-2.177,-2.711,both P<0.05).The correlation analysis showed that the MK and Kr value of the anterior limb of the internal capsule and the MK value of the posterior limb of the internal capsule were positively correlated with the score of the gross motor functional area(r=0.379,0.378,0.405,all P<0.05),and the MK value of the posterior limb of the internal capsule was positively correlated with the fine motor functional area(r=0.461,P=0.006).The Kr value of the thalamus had the largest area under the curve at 0.721 when diagnosing GDD.Conclusion Children with GDD have changes in brain microstructure,and DKI has a certain value for diagnosis.