Oliverio P J, Monsein L H, Wand G S, Debrun G M
Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA.
AJNR Am J Neuroradiol. 1996 Oct;17(9):1669-74.
To determine whether bilateral, simultaneous, cavernous sinus sampling after corticotropin-releasing hormone (CRH) stimulation offers as accurate detection and lateralization of Cushing disease as inferior petrosal sinus sampling does.
Seventeen consecutive patients with hypercortisolism and with high-dose dexamethasone suppression test results suggesting Cushing disease underwent bilateral cavenous sinus sampling with CRH stimulation. The diagnosis of Cushing disease was established in all patients by histologic examination or, if no tumor was found at surgery, by subtotal resection of the gland or radiation therapy resulting in eventual hypocortisolism or normal adrenal function and clinical remission.
The sensitivity of cavenous sinus sampling with and without CRH in detecting Cushing disease was 94% and 71%, respectively. The abnormal side of the pituitary was correctly identified in all patients who had criteria for lateralization, yielding a positive predictive value of 100%.
This small series suggests that cavernous sinus sampling with CRH is as accurate as inferior petrosal sinus sampling in detecting Cushing disease and perhaps more accurate in lateralizing the abnormality within the pituitary gland.
确定促肾上腺皮质激素释放激素（CRH）刺激后双侧同时进行海绵窦采样在检测库欣病以及对其进行定位方面是否与岩下窦采样一样准确。
17例连续的高皮质醇血症患者，其大剂量地塞米松抑制试验结果提示库欣病，接受了CRH刺激下的双侧海绵窦采样。所有患者的库欣病诊断均通过组织学检查确立，或者如果手术中未发现肿瘤，则通过腺体次全切除或放射治疗，最终导致皮质醇减少或肾上腺功能正常以及临床缓解来确立。
有CRH和无CRH时海绵窦采样检测库欣病的敏感性分别为94%和71%。在所有有定位标准的患者中，垂体异常侧均被正确识别，阳性预测值为100%。
这个小系列研究表明，CRH刺激下的海绵窦采样在检测库欣病方面与岩下窦采样一样准确，并且在垂体异常定位方面可能更准确。
