STUDIES OF HUMAN PITUITARY TUMORS

人类垂体肿瘤的研究

• 批准号: 3860800
• 负责人: E H OLDFIELD
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3860800
• 关键词: Cushing's syndrome; adenoma; adrenocorticotropic hormone; biopsy; contrast media; diagnosis quality /standard; endocrine disorder diagnosis; human subject; human tissue; magnetic resonance imaging; neoplasm /cancer diagnosis; neoplasm /cancer surgery; pituitary neoplasms

We investigated venous sampling of the pituitary venous drainage to aid in the diagnosis and treatment of patients with Cushing's syndrome. Over 450 patients have now received bilateral simultaneous inferior petrosal sinus (IPS) sampling. The results indicate that 1) the procedure can be performed successfully in all patients with Cushing's syndrome (successful sampling has been performed in over 99% of the patients in whom it has been attempted); 2) the procedure distinguishes patients with ectopic ACTH secretion from those with pituitary adenomas with 100% accuracy; 3) IPS sampling successfully determines in which side of the pituitary gland microadenomas reside in patients with Cushing's disease with 70% accuracy; and 4) unilateral inferior petrosal sinus sampling, which is commonly used clinically, is frequently misleading. Repeat transsphenoidal surgery is successful in eliminating the hypercortisolism of Cushing's disease in about 70% of patients. This therapy for patients with Cushing's disease after previous pituitary surgery had not previously been examined. MRI scanning with and without gadolinium-EDTA was used to evaluate patients with Cushing's disease preoperatively. This technique permitted identification of the adenoma in about 55% of those patients with surgically proven microadenomas. Proper timing of the MRI after administration of gadolinium-EDTA was critical in the optimal use of the technique. Pituitary adenomas were detected in 15% of 100 normal subjects with MRI scanning with contrast.

我们研究了垂体静脉引流的静脉取样