中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2012年
7期
537-541
,共5页
周薇薇%王卫庆%张华%苏颋为%蔡剑飞%蒋怡然%方文强%孙青芳%卞留贯%宁光
週薇薇%王衛慶%張華%囌颋為%蔡劍飛%蔣怡然%方文彊%孫青芳%卞留貫%寧光
주미미%왕위경%장화%소정위%채검비%장이연%방문강%손청방%변류관%저광
ACTH依赖性库欣综合征%双侧岩下窦静脉采血%大剂量地塞米松抑制试验
ACTH依賴性庫訢綜閤徵%雙側巖下竇靜脈採血%大劑量地塞米鬆抑製試驗
ACTH의뢰성고흔종합정%쌍측암하두정맥채혈%대제량지새미송억제시험
ACTH-dependent Cushing's syndrome%Bilateral inferior petrosal sinus sampling%High dosage dexamethasone suppression test
目的 评估双侧岩下窦静脉采血(BIPSS)测定ACTH、垂体MRI动态增强和大剂量地塞米松抑制试验在ACTH依赖性库欣综合征鉴别诊断中的价值.方法 纳入BIPSS并经病理明确诊断的ACTH 依赖性库欣综合征患者87例,行BIPSS、大剂量地塞米松抑制试验和垂体影像学评估.结果 78例病理明确诊断为垂体ACTH瘤,9例为胸腺类癌所致异位ACTH综合征.大剂量地塞米松抑制试验、垂体MRI动态增强和BIPSS诊断敏感性分别为82.1％、79.5％和92.3％,特异性分别为100％、44.4％和100％,诊断准确率分别为83.9％、77.0％和93.1％.库欣病患者BIPSS分侧定位符合率为83.9％,而垂体MRI分侧定位符合率为64.5％.结论 ACTH依赖性库欣综合征中,BIPSS比大剂量地塞米松抑制试验、垂体MRI 动态增强诊断符合率更高.与垂体MRI检查相比,BIPSS分侧定位更为可信.
目的 評估雙側巖下竇靜脈採血(BIPSS)測定ACTH、垂體MRI動態增彊和大劑量地塞米鬆抑製試驗在ACTH依賴性庫訢綜閤徵鑒彆診斷中的價值.方法 納入BIPSS併經病理明確診斷的ACTH 依賴性庫訢綜閤徵患者87例,行BIPSS、大劑量地塞米鬆抑製試驗和垂體影像學評估.結果 78例病理明確診斷為垂體ACTH瘤,9例為胸腺類癌所緻異位ACTH綜閤徵.大劑量地塞米鬆抑製試驗、垂體MRI動態增彊和BIPSS診斷敏感性分彆為82.1％、79.5％和92.3％,特異性分彆為100％、44.4％和100％,診斷準確率分彆為83.9％、77.0％和93.1％.庫訢病患者BIPSS分側定位符閤率為83.9％,而垂體MRI分側定位符閤率為64.5％.結論 ACTH依賴性庫訢綜閤徵中,BIPSS比大劑量地塞米鬆抑製試驗、垂體MRI 動態增彊診斷符閤率更高.與垂體MRI檢查相比,BIPSS分側定位更為可信.
목적 평고쌍측암하두정맥채혈(BIPSS)측정ACTH、수체MRI동태증강화대제량지새미송억제시험재ACTH의뢰성고흔종합정감별진단중적개치.방법 납입BIPSS병경병리명학진단적ACTH 의뢰성고흔종합정환자87례,행BIPSS、대제량지새미송억제시험화수체영상학평고.결과 78례병리명학진단위수체ACTH류,9례위흉선유암소치이위ACTH종합정.대제량지새미송억제시험、수체MRI동태증강화BIPSS진단민감성분별위82.1％、79.5％화92.3％,특이성분별위100％、44.4％화100％,진단준학솔분별위83.9％、77.0％화93.1％.고흔병환자BIPSS분측정위부합솔위83.9％,이수체MRI분측정위부합솔위64.5％.결론 ACTH의뢰성고흔종합정중,BIPSS비대제량지새미송억제시험、수체MRI 동태증강진단부합솔경고.여수체MRI검사상비,BIPSS분측정위경위가신.
Objective To evaluate the values of bilateral inferior petrosal sinus sampling ( BIPSS),high dosage dexamethasone suppression test (HDDST) and pituitary image in the differential diagnosis of ACTH-dependent Cushing's syndrome. Methods Totally 87 patients with confirmed pathological diagnosis were recruited in the study.All received the procedure of BLPSS,HDDST,and pituitary MRI with dynamic enhancement.The diagnostic performances of three differential diagnosis methods in ACTH-dependent Cushing's syndrome were evaluated.Results Seventy-eight patients were diagnosed as cases of pituitary ACTH adenoma,and the remaining 9 were confirmed cases of ectopic ACTH syndrome due to the thymic carcinoid.The sensitivity and specificity of HDDST,pituitary MRI,and BIPSS for the diagnosis of ACTH-dependent Cushing's syndrome were 82.1％ and 100％,79.5％ and 44.4％,92.3％ and 100％,respectively.In Cushing's disease,the diagnostic accuracy was 83.9％ with HDDST,77.0％with pituitary MRI,and93.1％ with BIPSS.In those patients with Cushing's disease,the coincidence of lateralization was 83.9％ with BIPSS and 64.5％ with MRII.Conclusion BIPSS was better than the other two methods in differential diagnosis of ACTH-dependent Cushing's syndrome.Compared with the pituitary MRI,the concordant rate of BIPSS in lateralization of the tumor is higher,and it is more reliable.
