Comparing the results of bilateral inferior petrosal sinus sampling with MRI of the pituitary gland in diagnosing Cushing’s disease

Abstract

Objective: To compare the results of bilateral inferior petrosal sinus sampling with pituitary MRI in diagnosing Cushing's disease.
Methods: This cross-sectional descriptive study involved 15 patients (12 females, 3 males) diagnosed with ACTH-dependent Cushing's syndrome and those with Cushing's disease suspected of recurrence after
surgical treatment. These patients underwent MRI of the pituitary gland and bilateral inferior petrosal sinus sampling under DSA from October 2022 to October 2023.
Results: Bilateral inferior petrosal sinus sampling yielded positive results in 14 out of 15 patients and helped predict the location of the pituitary tumor in 12 of these patients. Among these 12, 7 patients had
predicted tumor locations that matched the findings observed on MRI (4 on the right side, 3 on the left).
Conclusion: Bilateral inferior petrosal sinus sampling is useful for confirming ACTH secretion from pituitary adenomas, especially when the tumor is too subtle to be detected on MRI. However, MRI remains more valuable in tumor localization. An accurate and comprehensive diagnosis of Cushing’s disease requires close integration of multiple diagnostic imaging techniques.