Value of bilateral inferior petrosal sinus sampling for preoperative diagnosis of adrenocorticotropic hormone microadenomas_West China Medical Journal

Authors：

LI Ruichun , BAO Gang , QI Lei , XIE Wanfu , WANG Maode , GUO Shiwen ,  XU Gaofeng

Department of Neurosurgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, P. R. China;

Corresponding author：

XU Gaofeng, Email: xgf_1972@163.com

Keywords：

Pituitary adenoma; Cushing disease; Inferior petrosal sinus

DOI：

10.7507/1002-0179.201712057

Video：

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ObjectiveTo explore the value of bilateral inferior petrosal sinus sampling (BIPSS) for preoperative diagnosis of adrenocorticotropic hormone (ACTH) microadenomas.MethodsWe retrospectively analyzed the clinical date of patients with ACTH microadenomas, who were experienced BIPSS preoperatively from October 2013 to May 2017. The qualitative and localized diagnostic significance of BIPSS was evaluated based on the criteria of the plasma ACTH concentration ratio of inferior petrosal sinus to ulnar vein (≥2), and the ratio of left to right inferior petrosal sinuses (≥1.4).ResultsFive patients (1 male and 4 females) were involved in the study. The mean age was (49.6±9.2) years, and the mean disease course was (17.2±7.5) months. The plasma ACTH concentration of all the cases ran up to the criterition of the ratio of inferior petrosal sinus to ulnar vein (≥2). Three cases were found that the actual locations of the microadenomas were inconsistent with the indications from the results of BIPSS. After the BIPSS procedure, there was no intracranial infection or death case, except that one patient suffered from ecchymoma and another one suffered from transient nausea.ConclusionBIPSS is valuable for qualitative diagnosis, but not effective for localization diagnosis of the ACTH microadenomas preoperatively.

Citation： LI Ruichun, BAO Gang, QI Lei, XIE Wanfu, WANG Maode, GUO Shiwen, XU Gaofeng. Value of bilateral inferior petrosal sinus sampling for preoperative diagnosis of adrenocorticotropic hormone microadenomas. West China Medical Journal, 2018, 33(6): 723-726. doi: 10.7507/1002-0179.201712057 Copy

1.	马翔宇, 张鑫, 李卫国, 等. 神经内镜下经鼻蝶入路垂体 ACTH 腺瘤切除术 47 例临床分析. 中华神经外科杂志, 2014, 30(10): 1012-1015.
2.	Mehta G, Lonser RR, Oldfield EH. The history of pituitary surgery for Cushing disease. J Neurosurg, 2012, 116(2): 261-268.
3.	Deipolyi A, Bailin A, Hirsch JA, et al. Bilateral inferior petrosal sinus sampling: experience in 327 patients. J Neurointerv Surg, 2017, 9(2): 196-199.
4.	Shi X, Sun Q, Bian L, et al. Assessment of bilateral inferior petrosal sinus sampling in the diagnosis and surgical treatment of the ACTH-dependent Cushing’s syndrome: a comparison with other tests. Neuro Endocrinol Lett, 2011, 32(6): 865-873.
5.	范长燕, 何新尧, 施秀华, 等. 双侧岩下窦采血方法对难治性库欣病的诊治疗效. 中华内分泌外科杂志, 2013, 7(3): 250-252.
6.	Pivonello R, De Leo M, Cozzolino A, et al. The treatment of Cushing’s disease. Endocr Rev, 2015, 36(4): 385-486.
7.	Boscaro M, Ludlam WH, Atkinson B, et al. Treatment of pituitary-dependent Cushing’s disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase Ⅱ trial. J Clin Endocrinol Metab, 2009, 94(1): 115-122.
8.	Harker P, Feo-Lee O, Giraldo-Grueso M, et al. Effectiveness of bilateral inferior petrosal sinuses sampling in tumor lateralization: intraoperative findings and postoperative results. J Neurol Surg B Skull Base, 2017, 78(6): 506-511.
9.	Sharma ST, Nieman LK. Is prolactin measurement of value during inferior petrosal sinus sampling in patients with adrenocorticotropichormone-dependent Cushing’s Syndrome?. J Endocrinol Invest, 2013, 36(11): 1112-1116.
10.	Zampetti B, Grossrubatscher E, Dalino CP, et al. Bilateral inferior petrosal sinus sampling. Endocr connect, 2016, 5(4): 12-25.
11.	吴志远, 张华, 吴达明, 等. 双侧岩下窦采样诊断 ACTH 依赖性库欣综合征的应用研究. 介入放射学杂志, 2010, 19(5): 361-364.
12.	张楠, 李士其, 王镛斐, 等. 经蝶手术治疗临床表现为库欣病的垂体 ACTH 腺瘤 (附 29 例报告). 中国临床神经科学, 2012, 20(3): 295-299.
13.	Deipolvi A, Bailin A, Hirsch JA, et al. Bilateral inferior petrosal sinus samping: experience in 327 patients. J Neurointerv Surg, 2017, 9(2): 196-199.
14.	Silva JM, Aguiar GB, Conti ML, et al. Technical and functional aspects of catheterization of inferior petrosal sinuses in ACTH dependent Cushing’s syndrome. Arq Bras Endocrinol Metabol, 2014, 58(7): 758-764.

1. 马翔宇, 张鑫, 李卫国, 等. 神经内镜下经鼻蝶入路垂体 ACTH 腺瘤切除术 47 例临床分析. 中华神经外科杂志, 2014, 30(10): 1012-1015.
2. Mehta G, Lonser RR, Oldfield EH. The history of pituitary surgery for Cushing disease. J Neurosurg, 2012, 116(2): 261-268.
3. Deipolyi A, Bailin A, Hirsch JA, et al. Bilateral inferior petrosal sinus sampling: experience in 327 patients. J Neurointerv Surg, 2017, 9(2): 196-199.
4. Shi X, Sun Q, Bian L, et al. Assessment of bilateral inferior petrosal sinus sampling in the diagnosis and surgical treatment of the ACTH-dependent Cushing’s syndrome: a comparison with other tests. Neuro Endocrinol Lett, 2011, 32(6): 865-873.
5. 范长燕, 何新尧, 施秀华, 等. 双侧岩下窦采血方法对难治性库欣病的诊治疗效. 中华内分泌外科杂志, 2013, 7(3): 250-252.
6. Pivonello R, De Leo M, Cozzolino A, et al. The treatment of Cushing’s disease. Endocr Rev, 2015, 36(4): 385-486.
7. Boscaro M, Ludlam WH, Atkinson B, et al. Treatment of pituitary-dependent Cushing’s disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase Ⅱ trial. J Clin Endocrinol Metab, 2009, 94(1): 115-122.
8. Harker P, Feo-Lee O, Giraldo-Grueso M, et al. Effectiveness of bilateral inferior petrosal sinuses sampling in tumor lateralization: intraoperative findings and postoperative results. J Neurol Surg B Skull Base, 2017, 78(6): 506-511.
9. Sharma ST, Nieman LK. Is prolactin measurement of value during inferior petrosal sinus sampling in patients with adrenocorticotropichormone-dependent Cushing’s Syndrome?. J Endocrinol Invest, 2013, 36(11): 1112-1116.
10. Zampetti B, Grossrubatscher E, Dalino CP, et al. Bilateral inferior petrosal sinus sampling. Endocr connect, 2016, 5(4): 12-25.
11. 吴志远, 张华, 吴达明, 等. 双侧岩下窦采样诊断 ACTH 依赖性库欣综合征的应用研究. 介入放射学杂志, 2010, 19(5): 361-364.
12. 张楠, 李士其, 王镛斐, 等. 经蝶手术治疗临床表现为库欣病的垂体 ACTH 腺瘤 (附 29 例报告). 中国临床神经科学, 2012, 20(3): 295-299.
13. Deipolvi A, Bailin A, Hirsch JA, et al. Bilateral inferior petrosal sinus samping: experience in 327 patients. J Neurointerv Surg, 2017, 9(2): 196-199.
14. Silva JM, Aguiar GB, Conti ML, et al. Technical and functional aspects of catheterization of inferior petrosal sinuses in ACTH dependent Cushing’s syndrome. Arq Bras Endocrinol Metabol, 2014, 58(7): 758-764.

West China Medical Journal

Value of bilateral inferior petrosal sinus sampling for preoperative diagnosis of adrenocorticotropic hormone microadenomas

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