What is an inferior petrosal sinus sampling?
What is an inferior petrosal sinus sampling?
Inferior petrosal sinus sampling (IPSS) is an invasive procedure in which adrenocorticotropic hormone (ACTH) levels are sampled from the veins that drain the pituitary gland; these levels are then compared with the ACTH levels in the peripheral blood to determine whether a pituitary tumor (as opposed to an ectopic …
When do you use inferior petrosal sinus sampling?
Inferior petrosal sinus sampling is recommended in cases of Cushing’s syndrome in which clinical, biochemical, or imaging studies have not clearly identified either a pituitary or an ectopic origin of the ACTH production.
Where is the inferior petrosal sinus?
The inferior petrosal sinus is a paired cranial venous channel that drains the cavernous sinus, midbrain, cerebellum and inner ear. This dural venous sinus emerges from the cavernous sinus within the middle cranial fossa and drains into the internal jugular vein.
What are brain sinuses?
The dural venous sinuses (also called dural sinuses, cerebral sinuses, or cranial sinuses) are venous channels found between the endosteal and meningeal layers of dura mater in the brain.
What is inferior petrosal sinus sampling?
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.
What does elevated ACTH in the inferior petrosal sinus indicate?
This example shows elevation of ACTH in the right inferior petrosal sinus, likely indicating a tumor in the right side of the pituitary gland causing Cushing’s Disease. Tips of the catheters in the inferior petrosal sinuses.
What is an inferior petrosal venogram?
The guidewire was removed, and an inferior petrosal sinus venogram was performed to evaluate contrast filling within the ipsilateral inferior petrosal (IPS) and cavernous sinuses as well as across the intracavernous sinus into the contralateral cavernous and inferior petrosal sinuses.
What is the normal venous drainage pattern of the petrosal sinuses?
Venous drainage of the petrosal sinuses can have varying patterns. Lateralization rates range from 58-100%. Nevertheless, IPSS may be helpful in guiding surgical planning, especially in the setting where vague abnormalities on MRI imaging exist.
