What is 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 …

How do you perform inferior petrosal sinus sampling?

How do we do an IPSS procedure? Typically under general anesthesia, we place small tubes (catheters) into the femoral veins (the main vein draining the legs) at the level of the groin. From there, under X-ray guidance, we navigate those catheters to the main veins which drain the Pituitary gland.

Is petrosal sinus sampling painful?

Although the procedure is not painful, you may experience minor pain when the catheter (tubing) is passed through the veins. You may also experience pain at the puncture site. Petrosal sinus sampling is an invasive procedure where blood samples are taken from each side of the veins that drain into the pituitary gland.

How would you differentiate Cushing’s disease from Cushing’s syndrome?

Cushing disease is a specific type of Cushing syndrome. It occurs when a pituitary tumor causes the body to make too much cortisol. Cushing disease is the most common form of endogenous (from the body) Cushing syndrome, and makes up about 70% of Cushing syndrome cases.

Is inferior petrosal sinus sampling safe?

Background and purpose: Inferior petrosal sinus sampling (IPSS) is a useful diagnostic technique in adrenocorticotropic hormone (ACTH)-dependent hypercortisolism with normal or equivocal MR imaging. The procedure is believed to be safe, with mostly minor complications.

Where is the petrosal sinus?

temporal bone
The superior petrosal sinus is a small, narrow dural venous sinus found within the anterolateral margin of the tentorium cerebelli. It spans from the cavernous to the transverse sinus by coursing through a shallow groove on the superior border of the petrous part of the temporal bone.

How long does an IPSS test take?

The catheters are then guided through the veins up into the vein near the pituitary gland. X-rays are taken to make sure the catheters are being guided to the correct place. A series of blood samples are taken over a period of 10 minutes.

How is Cushing’s syndrome diagnosed?

The 24-hour urinary cortisol test measures the amount of cortisol being produced within the urine over the course of an entire day. Levels higher than 50-100 micrograms per day in an adult suggest the presence of Cushing’s syndrome.

What blood tests diagnose Cushing’s disease?

Dexamethasone–CRH test The dexamethasone-CRH test shows whether excess cortisol is caused by Cushing’s syndrome or by something else. Some people have high cortisol levels off and on but don’t develop the long-term health effects of Cushing’s syndrome.

How long does a IPSS procedure take?

In my case they took blood levels for all three (both left and right IPS’s and the Peripheral) at 3min, 5min, and 10min.

What is a site of drainage of superior petrosal sinus?

The superior petrosal sinus is one of the dural venous sinuses and drains the cavernous sinus. It courses posterolaterally to drain into the sigmoid sinus at the continuation of the transverse sinus. It runs along the superior aspect of the petrous temporal bone.