Ghorbani Mohammad, Akbari Hamideh, Griessenauer Christoph J, Wipplinger Christoph, Dastmalchi Alireza, Malek Mojtaba, Heydari Iraj, Mollahoseini Reza, Khamseh Mohammad E
Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Clinical Research Development Unit, Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran.
Heliyon. 2020 Oct 22;6(10):e05299. doi: 10.1016/j.heliyon.2020.e05299. eCollection 2020 Oct.
Inferior petrosal sinus sampling (IPSS) is known as the gold standard to distinguish whether excessive adrenocorticotropin hormone (ACTH) production origins from the pituitary gland or an ectopic source. However, due to a number of factors, the value of IPSS for adenoma lateralization may be limited. Aim of this study was to evaluate the influence of parasellar venous drainage (VD) patterns on IPSS findings in predicting lateralization of pituitary microadenomas.
We retrospectively reviewed records of confirmed cases of Cushing's disease which were evaluated by IPSS prior to endoscopic tansnasal trans-sphenoidal surgery (ETSS) to assess the ability of IPSS to predict adenoma laterality.
Seventeen patients with pathologically confirmed Cushing's disease were retrospectively reviewed. The median age of the included patients was 37 years. Laterality of parasellar VD perfectly associated with lateralization as measured by IPSS. Symmetrical VD was associated with symmetrical ACTH gradient on IPSS. However, lateralization measured by IPSS did not show any significant correlation with lateralization detected during ETSS.
Our study suggests that IPSS lateralization results strongly depend on parasellar VD pattern but show no significant correlation with the adenoma lateralization found during ETSS. Thus, IPSS does not appear to be an appropriate modality to predict adenoma lateralization.
岩下窦采血（IPSS）是区分促肾上腺皮质激素（ACTH）过度分泌源于垂体还是异位来源的金标准。然而，由于多种因素，IPSS在腺瘤定位方面的价值可能有限。本研究的目的是评估鞍旁静脉引流（VD）模式对IPSS结果在预测垂体微腺瘤定位中的影响。
我们回顾性分析了在内镜经鼻蝶窦手术（ETSS）前通过IPSS评估的库欣病确诊病例记录，以评估IPSS预测腺瘤侧别的能力。
回顾性分析了17例经病理证实的库欣病患者。纳入患者的中位年龄为37岁。鞍旁VD的侧别与IPSS测量的侧别完全相关。对称的VD与IPSS上的对称ACTH梯度相关。然而，IPSS测量的侧别与ETSS期间检测到的侧别无显著相关性。
我们的研究表明，IPSS侧别结果强烈依赖于鞍旁VD模式，但与ETSS期间发现的腺瘤侧别无显著相关性。因此，IPSS似乎不是预测腺瘤侧别的合适方法。
