Rampazzo A, Paoletta A, Giacomazzo G
Medicina (Firenze). 1989 Apr-Jun;9(2):198-200.
Previous reports have emphasized the value of bilateral and simultaneous catheterization of the inferior petrosal sinus for the measurement of both basal and oCRH (ovine Corticotropin Releasing Hormone) stimulated ACTH levels to determine the site of the microadenoma in the pituitary and for the differential diagnosis of Cushing's disease. This method is mainly employed in those patients whose hormonal studies are ambiguous and whose CT-scans and NMR (Nuclear-Magnetic-Resonance) results yield inconclusive or negative findings. Ten patients were studied: 9 were under evaluation for Cushing's disease and one was a "relapse" (4 yrs after transsphenoidal microadenomectomy). In all patients, except two who are awaiting surgery and one who was a "relapse", surgical findings were consistent with the ipsilateral hypersecretion (one had a central microadenoma). These results confirm that bilateral and simultaneous catheterization of the inferior petrosal sinus associated with a oCRH stimulus could be of great help in localizing the site of the adenoma and therefore improve the results of surgery. Moreover, this methodology may be of great value in diagnosing ectopic secretion.
先前的报告强调了双侧同时经岩下窦置管测定基础及促肾上腺皮质激素释放激素（羊促肾上腺皮质激素释放激素）刺激后的促肾上腺皮质激素水平对于确定垂体微腺瘤位置以及库欣病鉴别诊断的价值。该方法主要用于那些激素检查结果不明确且CT扫描和核磁共振结果无定论或呈阴性的患者。对10例患者进行了研究：9例正在接受库欣病评估，1例为“复发”患者（经蝶窦微腺瘤切除术后4年）。在所有患者中，除了2例等待手术的患者和1例“复发”患者外，手术结果均与同侧分泌亢进一致（1例有中央微腺瘤）。这些结果证实，双侧同时经岩下窦置管并给予促肾上腺皮质激素释放激素刺激对于腺瘤定位可能有很大帮助，从而提高手术效果。此外，这种方法在诊断异位分泌方面可能具有很大价值。
