Chan F L, Lam K S
Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital.
Ann Acad Med Singap. 1993 Sep;22(5):707-13.
Despite recent instrumentation advancement in morphologic imaging, venous sampling remains a sensitive physiological investigation for functional localization of hormonal hypersecretion. The test requires technical expertise and reliable laboratory support, and should be selectively applied to address individual clinical problems in coordination with other imaging modalities. Depending on the venous anatomy, sampling may achieve regional localization or lateralization of the endocrine tumour. Adrenal venous sampling serves to lateralize functioning tumour, and to differentiate it from hyperplasia. Inferior petrosal sinus sampling confirms pituitary Cushing's disease and lateralizes the adenoma. Systemic venous sampling identifies the site of ectopic hormonal secretion. In the localization of pancreatic islet cell tumours, the test is further enhanced by sampling after intraarterial injection of hormonal secretagogue. The experience of venous sampling in a regional referral hospital is discussed, including the patient selection, its technical details, pitfalls and effectiveness in achieving tumour localization for patient management.
尽管近期形态学成像技术有所进步，但静脉采样仍是一项用于激素分泌过多功能性定位的敏感生理学检查。该检查需要专业技术和可靠的实验室支持，应与其他成像方式协同，有选择地应用于解决个体临床问题。根据静脉解剖结构，采样可实现内分泌肿瘤的区域定位或侧别定位。肾上腺静脉采样用于确定功能性肿瘤的侧别，并将其与增生相鉴别。岩下窦采样可确诊垂体库欣病并确定腺瘤的侧别。全身静脉采样可确定异位激素分泌的部位。在胰岛细胞瘤的定位中，动脉内注射激素促分泌剂后进行采样可进一步提高该检查的效果。本文讨论了在一家区域转诊医院进行静脉采样的经验，包括患者选择、技术细节、陷阱以及在实现肿瘤定位以指导患者管理方面的有效性。
