Related Experiment Videos
Inferior petrosal sinus sampling in acromegaly
P A Crock1, E J Gilford, J K Henderson
1Endocrine Unit, St. Vincent's Hospital, Fitzroy, Vic, Australia.
Australian and New Zealand Journal of Medicine
|June 1, 1989
Summary
Bilateral simultaneous inferior petrosal sinus sampling (BSIPSS) is not helpful for locating pituitary tumors in acromegaly patients. This study found BSIPSS provided inaccurate localization, despite other hormone gradients, and surgery was successful without it.
Area of Science:
- Endocrinology
- Neurosurgery
- Diagnostic Imaging
Background:
- Pituitary adenomas cause hormonal imbalances like Cushing's disease and acromegaly.
- Accurate preoperative localization of microadenomas is crucial for surgical success.
- Bilateral simultaneous inferior petrosal sinus sampling (BSIPSS) is established for Cushing's disease localization.
Purpose of the Study:
- To evaluate the clinical utility of BSIPSS in acromegaly patients with unclear CT scans.
- To assess the accuracy of intersinus gradients for growth hormone (GH) and other pituitary hormones in acromegaly.
Main Methods:
- BSIPSS was performed on five acromegaly patients with equivocal or negative pituitary CT scans.
- Intersinus gradients for GH and other pituitary hormones (e.g., prolactin) were measured.
- Surgical findings were compared with BSIPSS results for tumor localization.
Main Results:
- Intersinus GH gradients (1.6-4.2) were observed in all patients, but only one correctly localized the tumor side.
- Parallel gradients were noted for other pituitary hormones, including prolactin (1.6-4.0).
- Surgeons successfully identified tumors intraoperatively despite inaccurate BSIPSS localization.
Conclusions:
- BSIPSS offers limited assistance for preoperative radiological evaluation in acromegaly.
- The study advises against the routine use of BSIPSS for all secretory pituitary microadenomas.
- Accurate tumor identification during surgery was achieved without reliable BSIPSS guidance.