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Christoph Ozdoba - One of the best experts on this subject based on the ideXlab platform.
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Selective Inferior Petrosal Sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in Cushing’s syndrome
Neuroradiology, 2012Co-Authors: Lukas Andereggen, Gerhard Schroth, Jan Gralla, Luigi Mariani, Jürgen Beck, H.r. Widmer, Robert H. Andres, Emanuel Christ, Rolf Seiler, Christoph OzdobaAbstract:Introduction Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing’s syndrome (CS). Bilateral Inferior Petrosal Sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma. Methods We performed BIPSS in 23 patients that met clinical and biochemical criteria of CS and with equivocal MRI findings. For BIPSS, the femoral veins were catheterized bilaterally with a 6-F catheter and the Inferior Petrosal Sinus bilaterally with a 2.7-F microcatheter. A third catheter was placed in the right femoral vein. Blood samples were collected from each catheter to determine ACTH blood concentration before and after oCRH stimulation. Results In 21 patients, a central-to-peripheral ACTH gradient was found and the affected side determined. In 18 of 20 patients where transsphenoidal partial hypophysectomy was performed based on BIPSS findings, microadenoma was histologically confirmed. BIPSS had a sensitivity of 94% and a specificity of 67% after oCRH stimulation in detecting a microadenoma. Correct localization of the adenoma was achieved in all Cushing’s disease patients. Conclusion BIPSS remains the gold standard in the detection of a microadenoma in CS. Our findings show that the selective placement of microcatheters without venous outflow diversion might further enhance better recognition to localize the pituitary tumor.
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selective Inferior Petrosal Sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in cushing s syndrome
Neuroradiology, 2012Co-Authors: Lukas Andereggen, Gerhard Schroth, Jan Gralla, Rolf W. Seiler, Luigi Mariani, Jürgen Beck, H.r. Widmer, Robert H. Andres, Emanuel Christ, Christoph OzdobaAbstract:Introduction Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing’s syndrome (CS). Bilateral Inferior Petrosal Sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma.
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Selective Inferior Petrosal Sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in Cushing’s syndrome
Neuroradiology, 2011Co-Authors: Lukas Andereggen, Gerhard Schroth, Jan Gralla, Rolf W. Seiler, Luigi Mariani, Jürgen Beck, H.r. Widmer, Robert H. Andres, Emanuel Christ, Christoph OzdobaAbstract:Introduction Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing’s syndrome (CS). Bilateral Inferior Petrosal Sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma.
Konstantine T Kalogeras - One of the best experts on this subject based on the ideXlab platform.
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Inferior Petrosal Sinus avp in patients with cushing s syndrome
Clinical Endocrinology, 1997Co-Authors: Jack A Yanovski, John L. Doppman, Theodore C Friedman, Lynnette K Nieman, George P Chrousos, Gordon B Cutler, Konstantine T KalogerasAbstract:OBJECTIVE In both normal volunteers and patients with Cushing's disease, one dominant Inferior Petrosal Sinus (IPS) contains higher concentrations of AVP and ACTH than the contralateral (non-dominant) IPS, but ovine corticotrophin-releasing hormone (oCRH)-stimulated AVP in the Petrosal Sinuses is greater in Cushing's disease than in normal volunteers. To distinguish whether greater oCRH-releasable AVP might be specifically related to the presence of a pituitary corticotrophinoma, or be due to hypercortisolism per se, we compared IPS AVP in patients with Cushing's disease with those of patients with other causes of Cushing's syndrome. PATIENTS Twenty-three patients with Cushing's disease, 16 patients with the syndrome of ectopic ACTH and seven patients with Cushing's syndrome of adrenal origin. MEASUREMENTS AVP and ACTH, measured both before and 3, 5 and 10 minutes after oCRH in the Petrosal Sinuses, and in a peripheral vein. RESULTS In all three groups, AVP concentrations were lateralized such that most of the AVP was found in one, dominant IPS. oCRH significantly increased IPS ACTH only in patients with Cushing's disease (P < 0.001), whereas it significantly increased dominant IPS AVP levels in all three patient groups (P < 0.01). However, neither dominant nor non-dominant IPS AVP (basal or oCRH-stimulated) were significantly different among patients with Cushing's disease, ectopic ACTH or Cushing's syndrome of adrenal origin. Basal and oCRH-stimulated IPS AVP were negatively correlated with urine free cortisol. CONCLUSIONS Inferior Petrosal Sinus AVP levels are similar in all forms of Cushing's syndrome, and thus the higher Inferior Petrosal Sinus AVP levels in patients with Cushing's disease compared with normal volunteers are unlikely to be related specifically to the presence of the pituitary corticotrophinoma. While AVP may play a role in pituitary corticotroph tumourigenesis or may be secreted by some pituitary corticotroph tumours, the observation that CRH-stimulated Inferior Petrosal Sinus AVP levels are higher in Cushing's disease than in normal volunteers appears most likely to be related to the low endogenous CRH levels induced by hypercortisolism, rather than a consequence of Cushing's disease itself. We hypothesize that low endogenous CRH leads to increased sensitivity of central nervous system CRH receptors to exogenous CRH, and thus to greater ovine CRH-stimulated AVP.
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Inferior Petrosal Sinus AVP in patients with Cushing's syndrome
Clinical endocrinology, 1997Co-Authors: Jack A Yanovski, John L. Doppman, Theodore C Friedman, Lynnette K Nieman, George P Chrousos, Gordon B Cutler, Konstantine T KalogerasAbstract:OBJECTIVE In both normal volunteers and patients with Cushing's disease, one dominant Inferior Petrosal Sinus (IPS) contains higher concentrations of AVP and ACTH than the contralateral (non-dominant) IPS, but ovine corticotrophin-releasing hormone (oCRH)-stimulated AVP in the Petrosal Sinuses is greater in Cushing's disease than in normal volunteers. To distinguish whether greater oCRH-releasable AVP might be specifically related to the presence of a pituitary corticotrophinoma, or be due to hypercortisolism per se, we compared IPS AVP in patients with Cushing's disease with those of patients with other causes of Cushing's syndrome. PATIENTS Twenty-three patients with Cushing's disease, 16 patients with the syndrome of ectopic ACTH and seven patients with Cushing's syndrome of adrenal origin. MEASUREMENTS AVP and ACTH, measured both before and 3, 5 and 10 minutes after oCRH in the Petrosal Sinuses, and in a peripheral vein. RESULTS In all three groups, AVP concentrations were lateralized such that most of the AVP was found in one, dominant IPS. oCRH significantly increased IPS ACTH only in patients with Cushing's disease (P
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Inferior Petrosal Sinus arginine vasopressin concentrations in normal volunteers and patients with Cushing's disease
The Journal of clinical endocrinology and metabolism, 1996Co-Authors: Theodore C Friedman, John L. Doppman, Jack A Yanovski, George P Chrousos, Gordon B Cutler, L K Nieman, Edward H. Oldfield, Philipw. Gold, Konstantine T KalogerasAbstract:In patients with Cushing's disease (CD), basal Inferior Petrosal Sinus arginine vasopressin (AVP) concentrations are greater than peripheral levels and are further increased by the administration of CRH. AVP has an interPetrosal Sinus gradient similar to that for ACTH, leading to the hypotheses that Petrosal Sinus AVP might either be derived from the corticotroph adenoma or be important for adenoma formation. To determine whether Petrosal Sinus AVP is truly increased in patients with CD, we compared Inferior Petrosal Sinus and peripheral venous AVP and ACTH levels in 23 patients with CD and 9 healthy volunteers before and after iv ovine CRH. In both groups, AVP and ACTH showed interPetrosal lateralization, such that greater levels of both hormones were found at each time point in a single dominant Petrosal Sinus. When both hormones exhibited lateralization (an interSinus gradient > 1.5), ACTH and AVP always lateralized together. In patients with CD, the ACTH interPetrosal Sinus lateralization correctly id...
John L. Doppman - One of the best experts on this subject based on the ideXlab platform.
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the hypoplastic Inferior Petrosal Sinus a potential source of false negative results in Petrosal sampling for cushing s disease
The Journal of Clinical Endocrinology and Metabolism, 1999Co-Authors: John L. Doppman, Richard Chang, George P Chrousos, Edward H. Oldfield, Constantine A Stratakis, Lynnette K NiemanAbstract:Our purpose was to describe the hypoplastic or plexiform Inferior Petrosal Sinus as a potential cause of false-negative sampling results in patients with Cushing's disease. Five hundred and one patients with surgically proven Cushing's disease and negative or equivocal magnetic resonance imaging scans of the pituitary gland underwent Petrosal Sinus sampling. Four patients (0.8%) with surgically proven Cushing's disease had false-negative results of Petrosal Sinus sampling. Retrograde Inferior Petrosal sinograms in these patients were reviewed to evaluate the anatomy of the Inferior Petrosal Sinuses for abnormalities that could have contributed to this misdiagnosis. In addition, the retrograde Inferior Petrosal sinograms of 100 consecutive patients were reviewed to establish the frequency of asymmetric and/or hypoplastic Inferior Petrosal Sinuses. All four patients with false-negative results of Petrosal sampling demonstrated a hypoplastic or plexiform Inferior Petrosal Sinus ipsilateral to an ACTH-secreting microadenoma. When the sampling catheter was in the hypoplastic Petrosal Sinus, retrograde sinograms from the contralateral side demonstrated anomalous drainage patterns on the side of the hypoplastic Sinus. Because the negative results of Petrosal Sinus sampling false-suggested the presence of the ectopic ACTH syndrome, curative transsphenoidal surgery in these four patients was delayed up to 31 months. We conclude that the presence of a unilateral hypoplastic or plexiform Inferior Petrosal Sinus can result in anomalous drainage from the pituitary gland that may lead to false-negative sampling results in patients with Cushing's disease.
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There is no simple answer to a rare complication of Inferior Petrosal Sinus sampling.
AJNR. American journal of neuroradiology, 1999Co-Authors: John L. DoppmanAbstract:Bilateral Inferior Petrosal Sinus sampling is the most reliable test to differentiate Cushing's disease from ectopic adrenocorticotropic hormone (ACTH) production. Catheters, whether preshaped polyethylene or coaxial Tracker systems, are supple and atraumatic. Retrograde venograms are gentle
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Inferior Petrosal Sinus avp in patients with cushing s syndrome
Clinical Endocrinology, 1997Co-Authors: Jack A Yanovski, John L. Doppman, Theodore C Friedman, Lynnette K Nieman, George P Chrousos, Gordon B Cutler, Konstantine T KalogerasAbstract:OBJECTIVE In both normal volunteers and patients with Cushing's disease, one dominant Inferior Petrosal Sinus (IPS) contains higher concentrations of AVP and ACTH than the contralateral (non-dominant) IPS, but ovine corticotrophin-releasing hormone (oCRH)-stimulated AVP in the Petrosal Sinuses is greater in Cushing's disease than in normal volunteers. To distinguish whether greater oCRH-releasable AVP might be specifically related to the presence of a pituitary corticotrophinoma, or be due to hypercortisolism per se, we compared IPS AVP in patients with Cushing's disease with those of patients with other causes of Cushing's syndrome. PATIENTS Twenty-three patients with Cushing's disease, 16 patients with the syndrome of ectopic ACTH and seven patients with Cushing's syndrome of adrenal origin. MEASUREMENTS AVP and ACTH, measured both before and 3, 5 and 10 minutes after oCRH in the Petrosal Sinuses, and in a peripheral vein. RESULTS In all three groups, AVP concentrations were lateralized such that most of the AVP was found in one, dominant IPS. oCRH significantly increased IPS ACTH only in patients with Cushing's disease (P < 0.001), whereas it significantly increased dominant IPS AVP levels in all three patient groups (P < 0.01). However, neither dominant nor non-dominant IPS AVP (basal or oCRH-stimulated) were significantly different among patients with Cushing's disease, ectopic ACTH or Cushing's syndrome of adrenal origin. Basal and oCRH-stimulated IPS AVP were negatively correlated with urine free cortisol. CONCLUSIONS Inferior Petrosal Sinus AVP levels are similar in all forms of Cushing's syndrome, and thus the higher Inferior Petrosal Sinus AVP levels in patients with Cushing's disease compared with normal volunteers are unlikely to be related specifically to the presence of the pituitary corticotrophinoma. While AVP may play a role in pituitary corticotroph tumourigenesis or may be secreted by some pituitary corticotroph tumours, the observation that CRH-stimulated Inferior Petrosal Sinus AVP levels are higher in Cushing's disease than in normal volunteers appears most likely to be related to the low endogenous CRH levels induced by hypercortisolism, rather than a consequence of Cushing's disease itself. We hypothesize that low endogenous CRH leads to increased sensitivity of central nervous system CRH receptors to exogenous CRH, and thus to greater ovine CRH-stimulated AVP.
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Inferior Petrosal Sinus AVP in patients with Cushing's syndrome
Clinical endocrinology, 1997Co-Authors: Jack A Yanovski, John L. Doppman, Theodore C Friedman, Lynnette K Nieman, George P Chrousos, Gordon B Cutler, Konstantine T KalogerasAbstract:OBJECTIVE In both normal volunteers and patients with Cushing's disease, one dominant Inferior Petrosal Sinus (IPS) contains higher concentrations of AVP and ACTH than the contralateral (non-dominant) IPS, but ovine corticotrophin-releasing hormone (oCRH)-stimulated AVP in the Petrosal Sinuses is greater in Cushing's disease than in normal volunteers. To distinguish whether greater oCRH-releasable AVP might be specifically related to the presence of a pituitary corticotrophinoma, or be due to hypercortisolism per se, we compared IPS AVP in patients with Cushing's disease with those of patients with other causes of Cushing's syndrome. PATIENTS Twenty-three patients with Cushing's disease, 16 patients with the syndrome of ectopic ACTH and seven patients with Cushing's syndrome of adrenal origin. MEASUREMENTS AVP and ACTH, measured both before and 3, 5 and 10 minutes after oCRH in the Petrosal Sinuses, and in a peripheral vein. RESULTS In all three groups, AVP concentrations were lateralized such that most of the AVP was found in one, dominant IPS. oCRH significantly increased IPS ACTH only in patients with Cushing's disease (P
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Inferior Petrosal Sinus arginine vasopressin concentrations in normal volunteers and patients with Cushing's disease
The Journal of clinical endocrinology and metabolism, 1996Co-Authors: Theodore C Friedman, John L. Doppman, Jack A Yanovski, George P Chrousos, Gordon B Cutler, L K Nieman, Edward H. Oldfield, Philipw. Gold, Konstantine T KalogerasAbstract:In patients with Cushing's disease (CD), basal Inferior Petrosal Sinus arginine vasopressin (AVP) concentrations are greater than peripheral levels and are further increased by the administration of CRH. AVP has an interPetrosal Sinus gradient similar to that for ACTH, leading to the hypotheses that Petrosal Sinus AVP might either be derived from the corticotroph adenoma or be important for adenoma formation. To determine whether Petrosal Sinus AVP is truly increased in patients with CD, we compared Inferior Petrosal Sinus and peripheral venous AVP and ACTH levels in 23 patients with CD and 9 healthy volunteers before and after iv ovine CRH. In both groups, AVP and ACTH showed interPetrosal lateralization, such that greater levels of both hormones were found at each time point in a single dominant Petrosal Sinus. When both hormones exhibited lateralization (an interSinus gradient > 1.5), ACTH and AVP always lateralized together. In patients with CD, the ACTH interPetrosal Sinus lateralization correctly id...
G Lombardi - One of the best experts on this subject based on the ideXlab platform.
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vasopressin levels in cushing s disease Inferior Petrosal Sinus assay response to corticotrophin releasing hormone and comparison with patients without cushing s disease
Clinical Endocrinology, 1996Co-Authors: A Colao, B Merola, Francesca S Tripodi, A Di Sarno, Diego Ferone, G Cerbone, Paolo Marzullo, Francoise Boudouresque, C Oliver, G LombardiAbstract:BACKGROUND Higher vasopressin (AVP) levels have been found in the Inferior Petrosal Sinus ipsilateral to the ACTH-secreting adenoma than in the contralateral one, suggesting a potential pathogenetic role of AVP in Cushing's disease. DESIGN In order to investigate AVP release, plasma ACTH and AVP concentrations were assayed in the Inferior Petrosal Sinuses and in the peripheral blood before and after CRH stimulation. PATIENTS Twenty patients with Cushing's disease and 12 with other pituitary diseases were subjected to simultaneous and bilateral Inferior Petrosal Sinus sampling for diagnostic purposes. Ten healthy sex and age-matched subjects served as control for peripheral AVP values. MEASUREMENTS Plasma ACTH concentrations were measured by RIA using commercial kits. Plasma AVP concentrations were assayed by RIA in acetone extracts of 1–2 ml plasma. RESULTS Plasma AVP levels in the Inferior Petrosal Sinuses were significantly higher in Cushing's disease than in patients with other pituitary diseases (P<0.05) and in both groups AVP levels were higher in the Inferior Petrosal Sinuses than in the peripheral blood (P<0.01). In Cushing's disease, ACTH, but not AVP levels, were higher in the Inferior Petrosal Sinus ipsilateral to the adenoma than in the contralateral one (P<0.01). Seven patients showed a significant ACTH and AVP increase (greater than 50% of baseline) after CRH stimulation in the Inferior Petrosal Sinus ipsilateral to the adenoma. Conversely, no change was found in AVP levels in the remaining 13 patients. When AVP values were analysed in relation to surgical cure, higher Inferior Petrosal Sinus levels (P<0.05) were found in 6 patients with poor outcome: 4 of these patients had significantly decreased plasma AVP concentrations (by 32–43% of baseline) after CRH bolus. Peripheral AVP levels were similar in healthy subjects and patients with Cushing's disease whereas they were significantly reduced in patients with other pituitary diseases (P<0.002). CONCLUSIONS The results of this study show that patients with Cushing's disease and poor surgical outcome had the highest AVP levels in our series. CRH administration caused different effects on AVP levels: it increased them in 35% of patients whereas there was no response in the remaining patients. On the basis of these findings, it is hypothesized that AVP might be involved in the persistence of ACTH hypersecretion in a subset of patients poorly responsive to surgery.
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Vasopressin levels in Cushing's disease: Inferior Petrosal Sinus assay, response to corticotrophin‐releasing hormone and comparison with patients without Cushing's disease
Clinical endocrinology, 1996Co-Authors: A Colao, Francesca S Tripodi, A Di Sarno, Diego Ferone, G Cerbone, Paolo Marzullo, Francoise Boudouresque, C Oliver, Bartolomeo Merola, G LombardiAbstract:BACKGROUND Higher vasopressin (AVP) levels have been found in the Inferior Petrosal Sinus ipsilateral to the ACTH-secreting adenoma than in the contralateral one, suggesting a potential pathogenetic role of AVP in Cushing's disease. DESIGN In order to investigate AVP release, plasma ACTH and AVP concentrations were assayed in the Inferior Petrosal Sinuses and in the peripheral blood before and after CRH stimulation. PATIENTS Twenty patients with Cushing's disease and 12 with other pituitary diseases were subjected to simultaneous and bilateral Inferior Petrosal Sinus sampling for diagnostic purposes. Ten healthy sex and age-matched subjects served as control for peripheral AVP values. MEASUREMENTS Plasma ACTH concentrations were measured by RIA using commercial kits. Plasma AVP concentrations were assayed by RIA in acetone extracts of 1–2 ml plasma. RESULTS Plasma AVP levels in the Inferior Petrosal Sinuses were significantly higher in Cushing's disease than in patients with other pituitary diseases (P
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corticotropin releasing hormone test improvement of the diagnostic accuracy of simultaneous and bilateral Inferior Petrosal Sinus sampling in patients with cushing syndrome
World Journal of Surgery, 1995Co-Authors: L Zarrilli, A Colao, B Merola, G La Tessa, R Spaziante, Francesca S Tripodi, A Di Sarno, L A Marzano, G LombardiAbstract:Twenty-six consecutive patients with ACTH-dependent Cushing syndrome were subjected to simultaneous, bilateral Inferior Petrosal Sinus sampling for ACTH assay before and after ACTH-releasing hormone (CRH) stimulation. The baseline ACTH Inferior Petrosal Sinus/periphery (IPS/P) ratio was > or = 2 in 12 of 26 patients (46%), whereas the CRH-stimulated IPS/P ratio was > or = 3 in 19 of 26 patients (73%). A pituitary adenoma, ACTH-secreting at immunostaining, was surgically proved in all of the 19 patients who had an ACTH IPS/P ratio > or = 2 basally or > or = 3 after the CRH test but also in three other patients who did not have such ratios. The value of the basal IPS/P ratio and the complete lack of ACTH increase after CRH led to the diagnosis of an ectopic ACTH syndrome in four patients: a bronchial carcinoid was found in three patients, and the site of the tumor was still unknown in the other. In conclusion, the CRH test improved the diagnostic accuracy of Inferior Petrosal Sinus sampling from 61.5% (12 pituitary, 4 ectopic) to 92.0% (19 pituitary, 4 ectopic). Thus it should be performed during the diagnostic process.
Lukas Andereggen - One of the best experts on this subject based on the ideXlab platform.
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Selective Inferior Petrosal Sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in Cushing’s syndrome
Neuroradiology, 2012Co-Authors: Lukas Andereggen, Gerhard Schroth, Jan Gralla, Luigi Mariani, Jürgen Beck, H.r. Widmer, Robert H. Andres, Emanuel Christ, Rolf Seiler, Christoph OzdobaAbstract:Introduction Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing’s syndrome (CS). Bilateral Inferior Petrosal Sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma. Methods We performed BIPSS in 23 patients that met clinical and biochemical criteria of CS and with equivocal MRI findings. For BIPSS, the femoral veins were catheterized bilaterally with a 6-F catheter and the Inferior Petrosal Sinus bilaterally with a 2.7-F microcatheter. A third catheter was placed in the right femoral vein. Blood samples were collected from each catheter to determine ACTH blood concentration before and after oCRH stimulation. Results In 21 patients, a central-to-peripheral ACTH gradient was found and the affected side determined. In 18 of 20 patients where transsphenoidal partial hypophysectomy was performed based on BIPSS findings, microadenoma was histologically confirmed. BIPSS had a sensitivity of 94% and a specificity of 67% after oCRH stimulation in detecting a microadenoma. Correct localization of the adenoma was achieved in all Cushing’s disease patients. Conclusion BIPSS remains the gold standard in the detection of a microadenoma in CS. Our findings show that the selective placement of microcatheters without venous outflow diversion might further enhance better recognition to localize the pituitary tumor.
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selective Inferior Petrosal Sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in cushing s syndrome
Neuroradiology, 2012Co-Authors: Lukas Andereggen, Gerhard Schroth, Jan Gralla, Rolf W. Seiler, Luigi Mariani, Jürgen Beck, H.r. Widmer, Robert H. Andres, Emanuel Christ, Christoph OzdobaAbstract:Introduction Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing’s syndrome (CS). Bilateral Inferior Petrosal Sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma.
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Selective Inferior Petrosal Sinus sampling without venous outflow diversion in the detection of a pituitary adenoma in Cushing’s syndrome
Neuroradiology, 2011Co-Authors: Lukas Andereggen, Gerhard Schroth, Jan Gralla, Rolf W. Seiler, Luigi Mariani, Jürgen Beck, H.r. Widmer, Robert H. Andres, Emanuel Christ, Christoph OzdobaAbstract:Introduction Conventional MRI may still be an inaccurate method for the non-invasive detection of a microadenoma in adrenocorticotropin (ACTH)-dependent Cushing’s syndrome (CS). Bilateral Inferior Petrosal Sinus sampling (BIPSS) with ovine corticotropin-releasing hormone (oCRH) stimulation is an invasive, but accurate, intervention in the diagnostic armamentarium surrounding CS. Until now, there is a continuous controversial debate regarding lateralization data in detecting a microadenoma. Using BIPSS, we evaluated whether a highly selective placement of microcatheters without diversion of venous outflow might improve detection of pituitary microadenoma.