Technical and functional aspects of catheterization of inferior petrosal sinuses in ACTH dependent Cushing's syndrome

• Published in: Arquivos brasileiros de endocrinologia e metabologia 2014-10, Vol.58 (7), p.758-764
• Main Authors: Silva, João Miguel de Almeida, Aguiar, Guilherme Brasileiro de, Conti, Mario Luiz Marques, Santos, Américo Rubens Leite dos, Lima Junior, José Viana, Veiga, José Carlos Esteves
• Format: Article
• Language: Portuguese
• Subjects: ACTH Syndrome, Ectopic - diagnosis; Adenoma - diagnosis; Adolescent; Adrenocorticotropic Hormone - blood; Adult; Catheterization, Central Venous - methods; Child; Cushing Syndrome - diagnosis; Diagnosis, Differential; False Negative Reactions; Female; Humans; Male; Middle Aged; Petrosal Sinus Sampling - methods; Pituitary Neoplasms - diagnosis; Prolactin - blood
• ISSN: 1677-9487
• DOI: 10.1590/0004-2730000003301

To describe and analyze technique for bilateral catheterization of inferior petrosal sinus in our service, discussing the difficulties and success rates found. Fourteen patients with suspected Cushing's syndrome underwent bilateral inferior petrosal sinuses (IPS) catheterization between 2009 and 2012. The technique for catheterization and for hormone analysis were described. The procedure was well tolerated by all patients, and adequate catheterization was achieved in 92.85% of cases. The diagnosis of Cushing's disease was confirmed in 10 cases. The result of IPS catheterization after CRH infusion was coherent in all cases, without false negatives. The catheterization of IPS, despite being an invasive technique, is a safe procedure. The objectives can be done properly in most cases. When well indicated, this procedure remains the gold standard in distinguishing the ectopic form to pituitary source in Cushing's syndrome.