ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (145 abstracts)
Localization of the catheters during Bilateral sampling of the inferior petrosal sinuses can impact diagnostic power?
Sabrina Chiloiro 1 , Alessandro Pedicelli 2 , Iacopo Valente 2 , Tommaso Tartaglione 2 , Antonio Bianchi 1 , Antonella Giampietro 1 , Chiara Bima 1 , Liverana Lauretti 3 , Carmelo Anile 3 , Alfredo Pontecorvi 1 & Laura De Marinis 1
1Pituitary Unit, Catholic University of the Sacred Heart, Rome, Italy; 2Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy; 3Department of Neurosurgery, Catholic University of the Sacred Heart, Rome, Italy.
Introduction: Bilateral sampling of the inferior petrosal sinuses (IPSS) is considerate actually the best diagnostic test for Cushing.
Patients and methods: We retrospectively reviewed our series of patients undergone IPSS for Cushing disease and we compared the difference between central and peripheral ACTH gradient in basal condition and after CRH stimulation in cases of localization of the tip of the catheters inside the inferior petrosal sinus or at the confluence of the inferior petrosal sinus into the internal jugular vein. All the pituitary contrasted Magnetic Resonance was blinded reviewed by two dedicated neuro-radiologist.
Results: A total of 10 patients achieved an IPSS with CRH stimulation suggestive for Cushing syndrome. Four patients had a MR visible pituitary adenomas. In any cases, infiltration of the para-sellar region was detected. At each time point of the CRH-test during IPSS (basal, +3, +5, +10, +15 min), central/peripheral ACTH gradient was higher in cases of localization of catheters inside the inferior petrol sinus (IPS) as compared to cases of localization of catheters outside (OIPS) the inferior petrosal sinus (respectively basal IPS: 9.3 pg/ml and OIPS: 3.8 pg/ml; +3 min: IPS: 68.9 pg/ml and OIPS: 27.8 pg/ml; +5 min: 35.5 pg/ml and OIPS: 19.9 pg/ml; +10 min: IPS: 123.9 pg/ml and OIPS: 10.9 pg/ml; +15 min: IPS: 16.2 pg/ml and OIPS: 12.2 pg/ml).
Conclusion: The localization of the catheters into the inferior petrosal sinus allow to achieve a higher diagnostic central/peripheral ACTH gradient as compared to other catheter localization.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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