Abstract
Because no single test is definitive for Cushing's disease (CD), establishing the diagnosis has remained a challenge that relies on building a critical mass of evidence. The differential diagnosis of corticotropin (ACTH)-dependent Cushing's syndrome (CS) traditionally has rested on noninvasive biochemical and radiologic testing. Bilateral inferior petrosal sinus sampling (BIPSS) is an invasive procedure that has become part of the diagnostic armamentarium surrounding CD. When used appropriately-that is, for patients who have biochemically confirmed ACTH-dependent CS but discordant biochemical or radiologic studies-BIPSS is the reference standard confirmatory test for CD.
MeSH terms
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Adrenocorticotropic Hormone / analysis*
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Adrenocorticotropic Hormone / blood*
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Cranial Sinuses / anatomy & histology
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Cranial Sinuses / diagnostic imaging
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Cranial Sinuses / surgery*
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Diagnosis, Differential
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Glucocorticoids / blood
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Glucocorticoids / metabolism
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Humans
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Intraoperative Complications / prevention & control
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Petrosal Sinus Sampling / adverse effects
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Petrosal Sinus Sampling / instrumentation
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Petrosal Sinus Sampling / methods*
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Pituitary ACTH Hypersecretion / blood*
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Pituitary ACTH Hypersecretion / diagnosis*
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Pituitary ACTH Hypersecretion / physiopathology
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Pituitary Gland / metabolism
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Pituitary Gland / physiopathology
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Predictive Value of Tests
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Radiography
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Sella Turcica / pathology
Substances
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Glucocorticoids
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Adrenocorticotropic Hormone