INVESTIGATION OF CUSHINGS-SYNDROME BY INFERIOR PETROSAL SINUS SAMPLING

Bilateral simultaneous inferior petrosal sinus sampling, in combinatio n with CRH stimulation, is now able to confirm the diagnosis of pituit ary-dependent Cushing's disease with near certainty. In expert hands, the procedure is straightforward and safe. As well as confirming the d ifferential diagnosis, the test may aid surgical success, especially i f no adenoma is apparent at transsphenoidal exploration. In this artic le, we review the technique and its interpretation and consider which patients should undergo the procedure.