Preoperative Lateralization of ACTH-Secreting Pituitary Microadenomas by Bilateral and Simultaneous Inferior Petrosal Venous Sinus Sampling

Abstract

PREVIOUS reports have established the utility of selective catheterization of the inferior petrosal sinus for determination of plasma ACTH concentrations in the diagnosis of pituitary-dependent hypercortisolism.^{1 2 3 4 5} Preliminary studies suggest that hormonal secretion from a laterally located microadenoma drains preferentially into the ipsilateral inferior petrosal sinus.^{6 7 8} If this occurs consistently, simultaneous sampling of bilateral venous blood should provide a means of localizing the microadenoma in one side of the pituitary gland, aiding the surgeon's search for small lesions or, if the microadenoma cannot be found, allowing excision of the half of the gland containing the tumor.In this study we correlated . . .