"corticotrophin-releasing hormone (CRH) is traditional and is administrated (1 μg/kg to a maximum dose of 100 µg IV 1,6,5) or"
"pre-CRH/DDAVP"
"Inferior petrosal sinus sampling was first performed via sequential jugular catheterisation in 1977 at the Walter Reed Army Medical Centre 6. In 1985 bilateral simultaneous sampling was shown to help lateralise the adenoma and enable hemi-hypophysectomy with good rates of remission 10. In 1986 the use of CRH was described 11."
"< 2:1 central:peripheral = ectopic source"
"< 3:1 central:peripheral = ectopic source"
"Inferior petrosal sinus sampling is most frequently indicated when patients have confirmed ACTH-dependent Cushing's syndrome, confirmed by high-dose dexamethasone suppression test 6. ACTH-secreting pituitary microadenomas, which account for 80% of non-adrenal, non-iatrogenic cases, may be inapparent on imaging in a substantial number of individuals 1. In this clinical context, inferior petrosal sinus sampling can help confirm a pituitary source and even lateralise the adenoma, which is helpful in guiding exploratory surgery."
"sequential, simultaneous samples (e.g. at 2 or 3, 5, 10 and 15 minutes) are then obtained 1,6,9"
Expected headings
"Indication"
"Interpretation of results"
"History"
"Inferior petrosal sinus sampling is an infrequently used method of confirming the presence of a hormonally active pituitary microadenoma when imaging alone has been insufficient. This technique can confirm that an excess hormone (e.g., ACTH) is being produced by the pituitary and may also help lateralise the microadenoma (although the latter is more contentious)."