Inferior Petrosal Sinus Sampling in the Diagnosis of Sellar Neuropathology

Tomycz, Nestor D.; Horowitz, Michael

doi:10.1016/j.nec.2009.01.003

Cited by 17 publications

(28 citation statements)

References 43 publications

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“…More serious complicationsboth neurological (nerve palsy [1%], subarachnoid hemorrhage, brainstem infarction, or contrast extravasation) and peripheral (e.g., pulmonary and deep vein thromboembolism)-have been reported but appear extremely rare. 35,61 Developments in endovascular materials, such as smaller, hydrophilic catheters and microcatheters and pressurized sacks for continuous catheter flushing, may minimize the risks of thromboembolic and hemorrhagic events. Unilateral femoral vein puncture using 9-Fr sheaths may reduce groin complications in obese patients.…”

Section: Evidence On the Use Of Petrosal Sinus Samplingmentioning

confidence: 99%

The role of inferior petrosal sinus sampling in ACTH-dependent Cushing's syndrome: review and joint opinion statement by members of the Italian Society for Endocrinology, Italian Society for Neurosurgery, and Italian Society for Neuroradiology

Giraldi

Cavallo

Tortora

et al. 2015

FOC

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In the management of adrenocorticotropic hormone (ACTH)–dependent Cushing's syndrome, inferior petrosal sinus sampling (IPSS) provides information for the endocrinologist, the neurosurgeon, and the neuroradiologist. To the endocrinologist who performs the etiological diagnosis, results of IPSS confirm or exclude the diagnosis of Cushing's disease with 80%–100% sensitivity and over 95% specificity. Baseline central-peripheral gradients have suboptimal accuracy, and stimulation with corticotropin-releasing hormone (CRH), possibly desmopressin, has to be performed. The rationale for the use of IPSS in this context depends on other diagnostic means, taking availability of CRH and reliability of dynamic testing and pituitary imaging into account. As regards the other specialists, the neuroradiologist may collate results of IPSS with findings at imaging, while IPSS may prove useful to the neurosurgeon to chart a surgical course. The present review illustrates the current standpoint of these 3 specialists on the role of IPSS.

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Section: Evidence On the Use Of Petrosal Sinus Samplingmentioning

confidence: 99%

The role of inferior petrosal sinus sampling in ACTH-dependent Cushing's syndrome: review and joint opinion statement by members of the Italian Society for Endocrinology, Italian Society for Neurosurgery, and Italian Society for Neuroradiology

Giraldi

Cavallo

Tortora

et al. 2015

FOC

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show abstract

“…However, it is generally agreed that BIPSS is indicated for ACTH-dependent hypercortisolemia 14,22 and when noninvasive assays yield equivocal results. 9,12,22 Because of the high prevalence of pituitary incidentalomas, some institutions routinely perform BIPSS for all patients evaluated for CD.…”

Section: Resultsmentioning

confidence: 99%

“…13,14 Pituitary and ectopic ACTH secretion can be distinguished by noninvasive laboratory assays -the CRH stimulation test, the high-dose dexamethasone suppression test, and crosssectional imaging. 12 The high-dose dexamethasone suppression test is the primary noninvasive diagnostic test; high-dose dexamethasone inhibits pituitary adenoma secretion of ACTH but does not usually inhibit ectopic ACTH sources of ACTH.…”

mentioning

confidence: 99%

Bilateral inferior petrosal sinus sampling in the diagnosis of Cushing disease

Deipolyi¹,

Öklü²

2015

JVD

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“…For example, when the IPS is hypoplastic (Type IV or C), BIPSS yields false-negative results (29). Furthermore, the IPSs are also asymmetric in as many as 40% of patients (13,30), leading to errors in lateralization. For this reason, venous angiography is routinely done during BIPSS prior to sampling to avoid such interpretative errors.…”

Section: Anatomic Considerationsmentioning

confidence: 99%

“…There is general consensus that BIPSS is indicated only once ACTH-dependent hypercortisolemia has been firmly established (13,22). In other words, BIPSS is not meant to diagnose Cushing syndrome, but to diagnose a pituitary source of ACTH hypersecretion.…”

Section: Accuracy and Utilitymentioning

confidence: 99%