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<meta name="DC.Title" content="The Impact of Cavernous Sinus Drainage Pattern on the Results of Venous Sampling in Patients With Suspected Cushing Syndrome" />
<meta name="DC.Identifier" content="10.3174/ajnr.A0745" />
<meta name="DC.Date" content="2008-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Selective venous sampling from the posterior portion of the cavernous sinus (CS) is recommended for the diagnosis of Cushing disease, because samples from the posterior portion yield higher adrenocorticotropic hormone (ACTH) levels than those from the anterior and middle portions. We prospectively assessed this intracavernous gradient of ACTH level to determine which site in the CS yields adequate sampling.

MATERIALS AND METHODS: In 5 patients with Cushing syndrome, cavernous sinography was performed to assess drainage pattern of the CS. Sampling was performed from the anterior, middle, and posterior parts of the CS, inferior petrosal sinus (IPS), and the peripheral vein. The ratio of the concentration in CS and IPS to that in peripheral blood plasma (C/P ratio) was calculated.

RESULTS: Cavernous sinography showed that the main drainage route was the IPS in 6 sides and that the pterygoid plexus (PP) was developed to the same extent as the IPS in 3 sides. In 1 patient, the CS drained mainly to the PP. In 1 patient with an ectopic lesion, no increase in ACTH level was detected. In 3 of 4 patients with Cushing disease, the highest C/P ratio was obtained from the posterior portion. In 1 patient whose main drainage route was the PP, the highest C/P ratio was obtained from the anterior portion. In this case, sampling data from the posterior portion and the IPS yielded false-negative results.

CONCLUSION: Understanding the drainage patterns of the CS is essential for interpretation of sampling data from the CS and avoiding false-negative results." />
<meta name="DC.Contributor" content="N. Hayashi" />
<meta name="DC.Contributor" content="M. Kurimoto" />
<meta name="DC.Contributor" content="M. Kubo" />
<meta name="DC.Contributor" content="N. Kuwayama" />
<meta name="DC.Contributor" content="K. Kurosaki" />
<meta name="DC.Contributor" content="S. Nagai" />
<meta name="DC.Contributor" content="S. Endo" />
<meta name="article:published_time" content="2008-01-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="The Impact of Cavernous Sinus Drainage Pattern on the Results of Venous Sampling in Patients With Suspected Cushing Syndrome" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Selective venous sampling from the posterior portion of the cavernous sinus (CS) is recommended for the diagnosis of Cushing disease, because samples from the posterior portion yield higher adrenocorticotropic hormone (ACTH) levels than those from the anterior and middle portions. We prospectively assessed this intracavernous gradient of ACTH level to determine which site in the CS yields adequate sampling.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; In 5 patients with Cushing syndrome, cavernous sinography was performed to assess drainage pattern of the CS. Sampling was performed from the anterior, middle, and posterior parts of the CS, inferior petrosal sinus (IPS), and the peripheral vein. The ratio of the concentration in CS and IPS to that in peripheral blood plasma (C/P ratio) was calculated.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; Cavernous sinography showed that the main drainage route was the IPS in 6 sides and that the pterygoid plexus (PP) was developed to the same extent as the IPS in 3 sides. In 1 patient, the CS drained mainly to the PP. In 1 patient with an ectopic lesion, no increase in ACTH level was detected. In 3 of 4 patients with Cushing disease, the highest C/P ratio was obtained from the posterior portion. In 1 patient whose main drainage route was the PP, the highest C/P ratio was obtained from the anterior portion. In this case, sampling data from the posterior portion and the IPS yielded false-negative results.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSION:&lt;/b&gt; Understanding the drainage patterns of the CS is essential for interpretation of sampling data from the CS and avoiding false-negative results.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2008/01/01" />
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<meta name="citation_issn" content="0195-6108" />
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<meta name="citation_author" content="N. Hayashi" />
<meta name="citation_author" content="M. Kurimoto" />
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<meta name="twitter:title" content="The Impact of Cavernous Sinus Drainage Pattern on the Results of Venous Sampling in Patients With Suspected Cushing Syndrome" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Selective venous sampling from the posterior portion of the cavernous sinus (CS) is recommended for the diagnosis of Cushing disease, because samples from the posterior portion yield higher adrenocorticotropic hormone (ACTH) levels than those from the anterior and middle portions. We prospectively assessed this intracavernous gradient of ACTH level to determine which site in the CS yields adequate sampling.

MATERIALS AND METHODS: In 5 patients with Cushing syndrome, cavernous sinography was performed to assess drainage pattern of the CS. Sampling was performed from the anterior, middle, and posterior parts of the CS, inferior petrosal sinus (IPS), and the peripheral vein. The ratio of the concentration in CS and IPS to that in peripheral blood plasma (C/P ratio) was calculated.

RESULTS: Cavernous sinography showed that the main drainage route was the IPS in 6 sides and that the pterygoid plexus (PP) was developed to the same extent as the IPS in 3 sides. In 1 patient, the CS drained mainly to the PP. In 1 patient with an ectopic lesion, no increase in ACTH level was detected. In 3 of 4 patients with Cushing disease, the highest C/P ratio was obtained from the posterior portion. In 1 patient whose main drainage route was the PP, the highest C/P ratio was obtained from the anterior portion. In this case, sampling data from the posterior portion and the IPS yielded false-negative results.

CONCLUSION: Understanding the drainage patterns of the CS is essential for interpretation of sampling data from the CS and avoiding false-negative results." />
<meta name="og-title" property="og:title" content="The Impact of Cavernous Sinus Drainage Pattern on the Results of Venous Sampling in Patients With Suspected Cushing Syndrome" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Selective venous sampling from the posterior portion of the cavernous sinus (CS) is recommended for the diagnosis of Cushing disease, because samples from the posterior portion yield higher adrenocorticotropic hormone (ACTH) levels than those from the anterior and middle portions. We prospectively assessed this intracavernous gradient of ACTH level to determine which site in the CS yields adequate sampling.

MATERIALS AND METHODS: In 5 patients with Cushing syndrome, cavernous sinography was performed to assess drainage pattern of the CS. Sampling was performed from the anterior, middle, and posterior parts of the CS, inferior petrosal sinus (IPS), and the peripheral vein. The ratio of the concentration in CS and IPS to that in peripheral blood plasma (C/P ratio) was calculated.

RESULTS: Cavernous sinography showed that the main drainage route was the IPS in 6 sides and that the pterygoid plexus (PP) was developed to the same extent as the IPS in 3 sides. In 1 patient, the CS drained mainly to the PP. In 1 patient with an ectopic lesion, no increase in ACTH level was detected. In 3 of 4 patients with Cushing disease, the highest C/P ratio was obtained from the posterior portion. In 1 patient whose main drainage route was the PP, the highest C/P ratio was obtained from the anterior portion. In this case, sampling data from the posterior portion and the IPS yielded false-negative results.

CONCLUSION: Understanding the drainage patterns of the CS is essential for interpretation of sampling data from the CS and avoiding false-negative results." />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">N. Hayashi</span>, <span class="highwire-citation-author" data-delta="1">M. Kurimoto</span>, <span class="highwire-citation-author" data-delta="2">M. Kubo</span>, <span class="highwire-citation-author" data-delta="3">N. Kuwayama</span>, <span class="highwire-citation-author" data-delta="4">K. Kurosaki</span>, <span class="highwire-citation-author" data-delta="5">S. Nagai</span> and <span class="highwire-citation-author" data-delta="6">S. Endo</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">January 2008,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">69-72; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A0745 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-8004--62004614712" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">N. Hayashi </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.%2BHayashi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hayashi%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AN.%2BHayashi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 29</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 1 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">January 2008 </div></div>
      
      
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      <div class="highwire-cite-title">The Impact of Cavernous Sinus Drainage Pattern on the Results of Venous Sampling in Patients With Suspected Cushing Syndrome</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">69-72; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0745 </span></div>
  
  
  
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      <div class="highwire-cite-title">The Impact of Cavernous Sinus Drainage Pattern on the Results of Venous Sampling in Patients With Suspected Cushing Syndrome</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Hayashi</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Kurimoto</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Kubo</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Kuwayama</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Kurosaki</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Nagai</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Endo</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">69-72; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0745 </span></div>
  
  
  
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