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Related Experiment Videos

Direct cavernous sinus sampling

S Aoki1, T Okubo, Y Sasaki

  • 1Department of Radiology, Faculty of Medicine, University of Tokyo, Japan.

Radiation Medicine
|September 1, 1993
PubMed
Summary
This summary is machine-generated.

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Superselective cavernous sinus (CS) sampling accurately diagnoses Cushing disease by showing higher ACTH levels than inferior petrosal sinus (IPS) sampling. This minimally invasive technique may eliminate the need for CRH stimulation or bilateral sampling.

Area of Science:

  • Endocrinology
  • Interventional Radiology
  • Neurosurgery

Background:

  • Functioning pituitary adenomas require accurate diagnosis for effective treatment.
  • Distinguishing the source of hormone overproduction, particularly ACTH in Cushing disease, is crucial.
  • Current diagnostic methods like inferior petrosal sinus sampling have limitations.

Purpose of the Study:

  • To assess the efficacy and safety of superselective cavernous sinus (CS) sampling for diagnosing functioning pituitary adenomas.
  • To compare the diagnostic yield of direct CS sampling versus inferior petrosal sinus (IPS) sampling.

Main Methods:

  • Direct CS sampling was performed using a mini-catheter in 18 patients with functioning pituitary adenomas.
  • Samples were collected from the CS and peripheral veins, and IPS sampling was also conducted.

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  • Hormone levels, specifically ACTH, were measured and ratios (CS/peripheral and IPS/peripheral) were calculated.

    • Main Results:

    • Successful CS sampling was achieved in most patients, with no complications reported.
    • The CS/peripheral ACTH ratio was significantly higher in Cushing disease patients compared to the IPS/peripheral ratio.
    • In other functioning adenomas, the CS/peripheral ratio was not significantly higher than the IPS/peripheral ratio.

    Conclusions:

    • Superselective CS sampling is a safe and potentially accurate method for diagnosing Cushing disease.
    • This technique demonstrates a superior ACTH gradient compared to IPS sampling in Cushing disease.
    • Direct CS sampling may offer diagnostic accuracy without the need for CRH stimulation or bilateral simultaneous sampling.