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• W2103266708 abstract "BACKROUND AND PURPOSE: Determining the cause of Cushing9s syndrome can be difficult. Bilateral inferior petrosal sinus (IPS) sampling after ovine corticotropin–releasing hormone (oCRH) stimulation is an established technique for the differentiation of pituitary from nonpituitary sources of adrenocorticotropic hormone (ACTH) production. The purpose of this study was to review our experience to determine the sensitivity and specificity of bilateral IPS sampling. METHODS: Between January 1990 and February 1997, 92 patients underwent 94 IPS sampling procedures. Indications for these patients with Cushing9s syndrome included no discrete lesion on MR images or CT scans, a discrete lesion present on images but equivocal peripheral ACTH sampling after oCRH stimulation, and persistent Cushing9s syndrome after trans-sphenoidal surgery. RESULTS: IPS sampling yielded six false-negative results and one false-positive result, manifesting an overall sensitivity of 92.2% and a specificity of 90.0% for detection of a pituitary source of ACTH after oCRH stimulation. Microadenoma lateralization by IPS sampling after oCRH stimulation agreed with the surgical location in 70.0% of the patients. The technical success rate of initial (presampling) bilateral IPS catheterization was 93.6%. Two serious complications occurred and consisted of a venous subarachnoid hemorrhage and a lower extremity deep venous thrombosis. CONCLUSION: Bilateral IPS sampling after oCRH stimulation is helpful in the evaluation of ACTH-dependent Cushing9s syndrome. False-negative results, however, suggest that the possibility of a pituitary source must still be considered when no response to oCRH is documented. Interpetrosal ACTH gradient alone is not sufficient to lateralize the tumor reliably." @default.
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• W2103266708 date "2000-04-01" @default.
• W2103266708 modified "2023-10-03" @default.
• W2103266708 title "Adrenocorticotropic hormone–dependent Cushing's Syndrome: Sensitivity and Specificity of Inferior Petrosal Sinus Sampling" @default.
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