Inferior Petrosal Venous Sinus Sampling

Chapter
Part of the Techniques in Interventional Radiology book series (TECHRAD)

Abstract

Cushing’s syndrome (CS) is most commonly due to exogenous glucocorticoid administration. The most common endogenous cause of CS (70–80 %) is an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma (Cushing’s disease) for which the treatment of choice is surgical excision. Confirming the diagnosis of a pituitary source and excluding ectopic sources of ACTH using biochemical testing and cross-sectional imaging are often challenging.

Keywords

Cushing’s syndrome Exogenous glucocorticoid administration Adrenocorticotropic hormone-secreting pituitary adenoma Pituitary adenoma Adenoma Cushing’s disease Surgery Ectopic source Biochemical testing Cross-sectional imaging Bilateral interior petrosal sinus sampling Peripheral venous sampling Corticotropin-releasing hormone Sensitivity Specificity Diagnosis 

Suggested Reading

  1. Boscaro M, Arnaldi G. Approach to the patient with possible Cushing’s syndrome. J Clin Endocrinol Metab. 2009;94:3121–31.PubMedCrossRefGoogle Scholar
  2. Deipolyi A, Karaosmanoğlu A, Habito C, Brannan S, Wicky S, Hirsch J, Oklu R. The role of bilateral inferior petrosal sinus sampling in the diagnostic evaluation of Cushing syndrome. Diagn Interv Radiol. 2012;18(1):132–8.PubMedGoogle Scholar
  3. Doppman JL, Nieman LK, Chang R, et al. Selective venous sampling from the cavernous sinuses is not a more reliable technique than sampling from the inferior petrosal sampling in Cushing’s syndrome. J Clin Endocrinol Metab. 1995;80:2485–9.PubMedCrossRefGoogle Scholar
  4. Ilias I, Chang R, Pacak K, et al. Jugular venous sampling: an alternative to petrosal sinus sampling for the diagnostic evaluation of adrenocorticotropic hormone-dependent Cushing’s syndrome. J Clin Endocrinol Metab. 2004;89:3795–800.PubMedCrossRefGoogle Scholar
  5. Newell-Price J, Trainer P, Besser M, Grossman A. The diagnosis and differential diagnosis of Cushing’s syndrome and pseudo-Cushing’s states. Endocr Rev. 1998;19:647–72.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of Interventional RadiologyBarts and the Royal LondonLondonUK
  2. 2.Department of RadiologyBarts and the London NHS TrustLondonUK

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