McCance D R, McIlrath E, McNeill A, Gordon D S, Hadden D R, Kennedy L, Sheridan B, Atkinson A B
Sir George E. Clark Metabolic Unit, Department of Radiology, Royal Victoria Hospital, Belfast, UK.
Clin Endocrinol (Oxf). 1989 Feb;30(2):157-66. doi: 10.1111/j.1365-2265.1989.tb03737.x.
Bilateral inferior petrosal sinus sampling was successfully performed in 12 of 13 consecutive patients with ACTH-dependent Cushing's syndrome. Ten of the patients subsequently had transsphenoidal pituitary microsurgery. Eight patients in whom the inferior petrosal sinus to peripheral vein ACTH level ratio was 1.5 or greater were found to have a pituitary adenoma. One of the remaining two patients who had ratios less than 1.5 had pituitary hyperplasia while the other had no identified abnormality. In five of the patients with pituitary tumour a ratio above 1.5 was present on only one side. Bilateral petrosal sampling is therefore always necessary. Tumour localization within the pituitary was only poorly predicted by either petrosal sinus sampling (four of eight) or computed tomography scanning (three of eight). If petrosal sinus sampling is used early in the differential diagnosis of ACTH-dependent hypercortisolism, then the use of other differential diagnostic tests may not always be necessary.
在连续13例促肾上腺皮质激素（ACTH）依赖性库欣综合征患者中，12例成功进行了双侧岩下窦采血。其中10例患者随后接受了经蝶窦垂体显微手术。岩下窦与外周静脉ACTH水平比值为1.5或更高的8例患者被发现患有垂体腺瘤。其余2例比值小于1.5的患者中，1例有垂体增生，另1例未发现异常。在5例垂体肿瘤患者中，仅一侧的比值高于1.5。因此，双侧岩下窦采血总是必要的。岩下窦采血（8例中的4例）或计算机断层扫描（8例中的3例）对垂体肿瘤的定位预测效果都很差。如果在ACTH依赖性皮质醇增多症的鉴别诊断早期使用岩下窦采血，那么可能并不总是需要使用其他鉴别诊断测试。
