Boolell M, Gilford E, Arnott R, McNeill P, Cummins J, Alford F
Endocrine Unit, St Vincent's Hospital, Melbourne, Vic., Australia.
Aust N Z J Med. 1990 Dec;20(6):765-70. doi: 10.1111/j.1445-5994.1990.tb00420.x.
This study examines the role of bilateral synchronous inferior petrosal sinus sampling (BSIPSS) in resolving two major issues in the pre-operative assessment of Cushing's disease, namely proof of pituitary dependent disease and accurate lateralisation of tumour within the pituitary. BSIPSS was technically successful in 16 of 20 patients. The central to peripheral ACTH gradients, supporting the diagnosis of pituitary dependent disease, was greater than 2.0 (2.0-27.2) in all patients with histologically proven ACTH-secreting pituitary tumours and in those who remained in remission following pituitary surgery. In addition, BSIPSS accurately localised the site of the tumour within the pituitary in 13 of the 16 technically satisfactory studies and thus contributed to the outcome of surgical treatment. In contrast CT scan demonstrated a definite tumour in only two patients.
本研究探讨双侧同步岩下窦采血（BSIPSS）在解决库欣病术前评估中的两个主要问题方面的作用，即垂体依赖性疾病的证实和垂体肿瘤的准确侧别定位。20例患者中有16例BSIPSS技术成功。在所有经组织学证实为促肾上腺皮质激素（ACTH）分泌性垂体肿瘤的患者以及垂体手术后仍处于缓解期的患者中，支持垂体依赖性疾病诊断的中央与外周ACTH梯度大于2.0（2.0 - 27.2）。此外，在16例技术满意的研究中，有13例BSIPSS准确地定位了垂体肿瘤的部位，从而有助于手术治疗的结果。相比之下，CT扫描仅在两名患者中显示出明确的肿瘤。
