Publicação
A cateterização dos seios petrosos inferiores no diagnóstico da doença de Cushing
| Resumo: | Determining the cause of Cushing‟s syndrome is often a diagnostic challenge. When hypercortisolemia stems from an ACTH-dependent process, about 70% of cases are due to a pituitary adenoma (Cushing‟s disease), 20% are caused by adrenal lesions and 10% are the result of ectopic ACTH secretion. In Cushing‟s disease, the treatment of choice is surgical removal of the pituitary adenoma. Thus, determining the source of ACTH is of importance. Biochemical and imaging tests may help in distinguishing the possible causes, but their accuracy is not ideal. Bilateral inferior petrosal sinus sampling is an interventional neuroradiology procedure used in the differential diagnosis of ATCHdependent Cushing‟s syndrome. It relies on the measurement of blood ACTH gradients between the inferior petrosal sinuses and a peripheral vein and is considered the gold standard for this purpose, due to its high sensitivity and specificity, safety and rarity of complications. This article describes the diagnosis of Cushing‟s disease, focusing on the use of inferior petrosal sinus sampling. |
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| Autores principais: | Souto, André Teixeira Branco Lima do |
| Assunto: | Síndrome de Cushing Seios petrosos inferiores Radiologia |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Determining the cause of Cushing‟s syndrome is often a diagnostic challenge. When hypercortisolemia stems from an ACTH-dependent process, about 70% of cases are due to a pituitary adenoma (Cushing‟s disease), 20% are caused by adrenal lesions and 10% are the result of ectopic ACTH secretion. In Cushing‟s disease, the treatment of choice is surgical removal of the pituitary adenoma. Thus, determining the source of ACTH is of importance. Biochemical and imaging tests may help in distinguishing the possible causes, but their accuracy is not ideal. Bilateral inferior petrosal sinus sampling is an interventional neuroradiology procedure used in the differential diagnosis of ATCHdependent Cushing‟s syndrome. It relies on the measurement of blood ACTH gradients between the inferior petrosal sinuses and a peripheral vein and is considered the gold standard for this purpose, due to its high sensitivity and specificity, safety and rarity of complications. This article describes the diagnosis of Cushing‟s disease, focusing on the use of inferior petrosal sinus sampling. |
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