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Selective venous catheterization in the evaluation of hyperandrogenism
C Bricaire1, A Raynaud, A Benotmane
1Department of Endocrinology and Reproductive Medicine, Hôpital Necker, France.
Journal of Endocrinological Investigation
|December 1, 1991
Summary
Selective catheterization accurately diagnosed occult ovarian tumors and identified non-tumoral hyperandrogeny in patients with high testosterone levels, reducing the need for exploratory surgery.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Oncology
Background:
- Elevated plasma testosterone levels necessitate accurate localization of androgen-producing tumors.
- Conventional imaging (ultrasonography, CT scan) can fail to detect occult ovarian tumors.
Purpose of the Study:
- To evaluate the diagnostic utility of retrograde bilateral ovarian-adrenal vein catheterization in patients with hyperandrogenism.
- To differentiate between tumoral and non-tumoral causes of androgen excess.
Main Methods:
- Selective catheterization of ovarian and adrenal veins in 16 patients with testosterone levels >1.4 ng/ml.
- Measurement of testosterone gradients between ovarian/adrenal veins and peripheral veins.
- Histopathological confirmation of diagnosed tumors.
Main Results:
- Occult ovarian tumors were diagnosed in 5 patients via unilateral ovarian-adrenal vein testosterone gradients.
- A virilizing adrenal tumor was identified in one patient with adrenal-peripheral vein testosterone gradient.
- Non-tumoral hyperandrogeny (polycystic ovary syndrome, hyperplasia) was diagnosed in 10 patients.
Conclusions:
- Selective catheterization is effective in diagnosing androgen-producing tumors, including occult ovarian and adrenal neoplasms.
- This technique aids in distinguishing tumoral from non-tumoral hyperandrogenism, guiding surgical management.
- Selective catheterization can reduce unnecessary exploratory surgeries.