Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Miller, D. L.
Right arrow Articles by Oldfield, E. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Miller, D. L.
Right arrow Articles by Oldfield, E. H.

Radiology, Vol 176, 429-431, Copyright © 1990 by Radiological Society of North America

ARTICLES

Petrosal sinus sampling: discordant lateralization of ACTH-secreting pituitary microadenomas before and after stimulation with corticotropin- releasing hormone

DL Miller, JL Doppman, LK Nieman, GB Cutler Jr, G Chrousos, DL Loriaux and EH Oldfield
Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892.

Petrosal sinus sampling was performed 171 times in 157 patients with known or suspected Cushing disease. In all cases, samples for measuring adrenocorticotropic hormone (ACTH) levels were obtained from both inferior petrosal sinuses and a peripheral vein, both before and after intravenous corticotropin-releasing hormone (CRH) administration. In seven examinations in seven patients, a ratio, or gradient, between the ACTH levels in the inferior petrosal sinuses existed in the samples obtained prior to CRH stimulation; however, poststimulation samples demonstrated reversal of the gradient, suggesting lateralization to the contralateral side of the pituitary gland. Data from surgical exploration of the pituitary gland were available for six of these patients, all of whom had adenomas. Prestimulation samples provided correct lateralization in three patients, and in two patients the poststimulation samples provided correct lateralization. One patient had a midline adenoma. When the results of pre- and poststimulation petrosal sinus sampling conflict, neither can be relied on uniformly to provide correct lateralization of ACTH-secreting pituitary adenomas.


This article has been cited by other articles:


Home page
 J. Clin. Endocrinol. Metab.Home page
V. Lefournier, M. Martinie, A. Vasdev, P. Bessou, J.-G. Passagia, F. Labat-Moleur, N. Sturm, J.-L. Bosson, I. Bachelot, and O. Chabre
Accuracy of Bilateral Inferior Petrosal or Cavernous Sinuses Sampling in Predicting the Lateralization of Cushing's Disease Pituitary Microadenoma: Influence of Catheter Position and Anatomy of Venous Drainage
J. Clin. Endocrinol. Metab., January 1, 2003; 88(1): 196 - 203.
[Abstract] [Full Text] [PDF]

Home page
 Endocr. Rev.Home page
J. Newell-Price, P. Trainer, M. Besser, and A. Grossman
The Diagnosis and Differential Diagnosis of Cushing's Syndrome and Pseudo-Cushing's States
Endocr. Rev., October 1, 1998; 19(5): 647 - 672.
[Abstract] [Full Text]

Home page
 J. Clin. Endocrinol. Metab.Home page
G. L. Booth, D. A. Redelmeier, H. Grosman, K. Kovacs, H. S. Smyth, and S. Ezzat
Improved Diagnostic Accuracy of Inferior Petrosal Sinus Sampling over Imaging for Localizing Pituitary Pathology in Patients with Cushing's Disease
J. Clin. Endocrinol. Metab., July 1, 1998; 83(7): 2291 - 2295.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
RADIOLOGY RADIOGRAPHICS RSNA JOURNALS ONLINE
Copyright © 1990 by the Radiological Society of North America.