The role of bilateral inferior petrosal sinus sampling in the diagnostic evaluation of Cushing syndrome

1. Department of Vascular Imaging and Interventions, Harvard University Medical School, Massachusetts General Hospital, Massachusetts, USA

2. Departments of Vascular Imaging and Interventions, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA

3. Department of Vascular Imaging and Interventions Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

4. Departments of Neurointerventional Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA

5. Division of Vascular Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

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Received Date: 08.02.2011

Accepted Date: 11.02.2011

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ABSTRACT

Bilateral inferior petrosal sinus sampling is the gold standard diagnostic assay in identifying the pituitary source of adrenocorticotropic hormone secretion in Cushing syndrome. The noninvasive assays used in the workup of Cushing syndrome are often misleading or ambiguous, yielding sensitivities of up to only 80%. Inferior petrosal sinus sampling, however, is highly accurate and safe when performed in experienced centers. We review here the historical and technical details of the procedure, with emphasis on the relevant anatomy and a discussion of possible rare complications.