Lateralization outcomes of bilateral inferior petrosal sinus sampling: desmopressin vs CRH.

IF 2.4 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Hormones-International Journal of Endocrinology and Metabolism Pub Date : 2024-12-16 DOI:10.1007/s42000-024-00620-4

Buruc Erkan, Mehmet Said Cil, Mehmet Cingoz, Sebnem Burhan, Seyma Aksoy, Sabahattin Yuzkan, Ebubekir Akpinar, Suat Demir, Osman Tanriverdi, Burak Kocak, Ilkay Cakir, Sema Ciftci, Feyza Yener Ozturk, Omur Gunaldi, Yuksel Altuntas, Mutlu Niyazioglu, Esra Suheda Hatipoglu

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引用次数: 0

Abstract

Purpose: Bilateral inferior petrosal sinus sampling (BIPSS) is the gold standard for localizing ACTH-dependent Cushing's syndrome (CS). While corticotropin-releasing hormone (CRH) was initially used for stimulation, desmopressin has become a common alternative. This research evaluates desmopressin's effectiveness in lateralizing Cushing's disease (CD) during BIPSS compared to CRH stimulation.

Methods: The study included 33 individuals with ACTH-dependent CS who underwent BIPSS and had diagnoses confirmed by endoscopic endonasal transsphenoidal pituitary surgery (EETPS). Fourteen participants underwent BIPSS with CRH and 19 with desmopressin. A comparative analysis was conducted.

Results: BIPSS accurately lateralized 76% of cases, specifically, 71% with CRH and 79% with desmopressin (p = 0.2). For tumors < 6 mm on MRI, overall accuracy was 82%, namely, 75% with CRH and 90% with desmopressin (p = 0.4). IPSS achieved 100% accuracy in the four cases with no lesion on preoperative MRI.

Conclusion: This study demonstrates no significant difference in lateralization accuracy between desmopressin and CRH for IPSS. In challenging cases, especially those with microadenomas or non-lesional CD, desmopressin with IPSS aids in preoperative lateralization.

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双侧下额窦取样的侧位结果：去氨加压素与 CRH。

目的：双侧岩下窦取样（BIPSS）是定位acth依赖性库欣综合征（CS）的金标准。虽然促肾上腺皮质激素释放激素（CRH）最初用于刺激，但去氨加压素已成为一种常见的替代方案。本研究评估了去氨加压素在BIPSS期间与CRH刺激相比对库欣病（CD）侧化的有效性。方法：本研究纳入33例acth依赖性CS患者，均行BIPSS，并经鼻内经蝶窦垂体手术（EETPS）确诊。14名参与者接受了CRH的BIPSS治疗，19名接受了去氨加压素治疗。进行了对比分析。结果：BIPSS准确地侧化了76%的病例，特别是71%的CRH和79%的去氨加压素（p = 0.2）。结论：本研究显示去氨加压素和CRH在IPSS的侧化准确性上无显著差异。在具有挑战性的病例中，特别是那些患有微腺瘤或非病变性乳糜泻的患者，去加压素联合IPSS有助于术前侧化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hormones-International Journal of Endocrinology and Metabolism ENDOCRINOLOGY & METABOLISM-

CiteScore

5.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hormones-International Journal of Endocrinology and Metabolism is an international journal published quarterly with an international editorial board aiming at providing a forum covering all fields of endocrinology and metabolic disorders such as disruption of glucose homeostasis (diabetes mellitus), impaired homeostasis of plasma lipids (dyslipidemia), the disorder of bone metabolism (osteoporosis), disturbances of endocrine function and reproductive capacity of women and men. Hormones-International Journal of Endocrinology and Metabolism particularly encourages clinical, translational and basic science submissions in the areas of endocrine cancers, nutrition, obesity and metabolic disorders, quality of life of endocrine diseases, epidemiology of endocrine and metabolic disorders.