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双侧岩下窦同时采样测定血清ACTH浓度对鉴别Cusbing氏病与异位ACTH综合症很有价值。该方法对于隐匿的垂体腺瘤也有用。至少80%的垂体ACTH腺瘤是微腺瘤,而几乎没有什么生长激素腺瘤是微腺瘤。Mayo医院的23例生长激素腺瘤中仅3例直径小于10mm,但35例生长泌乳激素混合腺瘤中9例为微腺瘤。今天,提倡肢端肥大症的早期诊断,该阶段血清生长激素水平在放射免疫方法测量中仅位于临界水平。作者对5例(男4例,女1例,27—68岁)有轻微肢端肥大症表现及血清生长激素水平轻微升高者作了经岩下窦采样。5例均作过CT,3例还作了MR。从外周静脉及左右岩下窦插管,分别同时采取静脉血。4例静脉注射1
Simultaneous sampling of bilateral inferior petrous sinuses to measure serum ACTH concentrations is valuable for the identification of Cussing’s disease and ectopic ACTH syndrome. This method is also useful for occult pituitary adenomas. At least 80% of pituitary ACTH adenomas are microadenomas, and almost no growth hormone adenomas are microadenomas. Of the 23 cases of growth hormone adenomas in Mayo Hospital, only 3 cases were less than 10 mm in diameter, but 9 of 35 cases of proliferative hormone mixed adenomas were microadenomas. Today, early diagnosis of acromegaly is advocated and serum levels of growth hormone levels are only at a critical level during radioimmunoassay measurements at this stage. The authors performed sub-subterranean sinus sampling in 5 cases (male 4, female 1 and 27-68 years old) with slight acromegaly and slightly elevated serum growth hormone levels. CT was performed in 5 cases and MR in 3 cases. Venous blood was taken at the same time from the peripheral vein and left and right petrous sinus cannula. 4 cases of intravenous injection 1