Arq Bras Endocrinol Metab 2014;58(7):758-764
Technical and functional aspects of catheterization of inferior petrosal sinuses in ACTH dependent Cushing’s syndrome
DOI: 10.1590/0004-2730000003301
Objective
To describe and analyze technique for bilateral catheterization of inferior petrosal sinus in our service, discussing the difficulties and success rates found.
Subjects and methods
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.
Results
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.
Conclusion
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.
Keywords: ACTH; catheterization; Cushing’s syndrome; petrosal sinus