[Use of catheterization of the inferior petrosal sinus in the diagnosis of Cushing's disease].

Previous reports have emphasized the value of bilateral and simultaneous catheterization of the inferior petrosal sinus for the measurement of both basal and oCRH (ovine Corticotropin Releasing Hormone) stimulated ACTH levels to determine the site of the microadenoma in the pituitary and for the differential diagnosis of Cushing's disease. This method is mainly employed in those patients whose hormonal studies are ambiguous and whose CT-scans and NMR (Nuclear-Magnetic-Resonance) results yield inconclusive or negative findings. Ten patients were studied: 9 were under evaluation for Cushing's disease and one was a "relapse" (4 yrs after transsphenoidal microadenomectomy). In all patients, except two who are awaiting surgery and one who was a "relapse", surgical findings were consistent with the ipsilateral hypersecretion (one had a central microadenoma). These results confirm that bilateral and simultaneous catheterization of the inferior petrosal sinus associated with a oCRH stimulus could be of great help in localizing the site of the adenoma and therefore improve the results of surgery. Moreover, this methodology may be of great value in diagnosing ectopic secretion.