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Use of magnetic resonance venography for inferior petrosal sinus sampling

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Title: Use of magnetic resonance venography for inferior petrosal sinus sampling
Authors: Tokairin, Kikutaro Browse this author
Osanai, Toshiya Browse this author
Fujima, Noriyuki Browse this author
Ishizaka, Kinya Browse this author
Motegi, Hiroaki Browse this author
Ishi, Yukitomo Browse this author
Kameda, Hiraku Browse this author
Sugiyama, Taku Browse this author
Kazumata, Ken Browse this author
Nakayama, Naoki Browse this author
Keywords: Inferior petrosal sinus
inferior petrosal sinus sampling
magnetic resonance
magnetic resonance venography
Issue Date: 1-May-2022
Publisher: SAGE Publications
Journal Title: Journal of vascular access
Volume: 23
Issue: 3
Start Page: 422
End Page: 429
Publisher DOI: 10.1177/1129729821997263
Abstract: Background: Inferior petrosal sinus (IPS) sampling (IPSS) is a transvenous interventional procedure performed to diagnose Cushing's disease. The reported IPSS failure rate is approximately 10% because IPS catheter delivery is conducted blindly and is challenging because of IPS anatomical variations. This study aimed to evaluate the usefulness of preprocedural magnetic resonance venography (MRV) for assessing IPS access routes before IPSS. Methods: Nineteen consecutive patients who underwent IPSS at a single university hospital in Japan were retrospectively studied. A preprocedural MRV protocol optimized to visualize the IPS before IPSS was established and utilized in the eight most recent cases. An IPSS procedure was considered successful when bilateral IPS catheterization was accomplished. Patient demographics, IPSS success rate, and radiation dose required during IPSS were compared between two groups: MRV group (N = 8) and no-MRV group (N = 11) before IPSS. Results: There were no significant differences in age, sex, and IPSS success rates between the groups. The average radiation dose was 663.6 +/- 246.8 (SD) mGy and 981.7 +/- 389.5 (SD) mGy in the MRV group and no-MRV group, respectively. Thus, there was a significant reduction in radiation exposure in the MRV group (p = 0.044). Catheterization of the left IPS was unsuccessful in only one patient in the MRV group owing to IPS hypoplasty, as found on the MRV. Conclusions: Hypoplastic IPSs occur in patients and can complicate IPSS. Preprocedural MRV assessment is useful for understanding venous anatomy and preventing unnecessary intravenous catheter manipulation during IPSS, which involves blind manipulation around the IPS.
Rights: Tokairin K, Osanai T, Fujima N, et al. Use of magnetic resonance venography for inferior petrosal sinus sampling. The Journal of Vascular Access. 2022;23(3):422-429. Copyright © 2021 (Copyright Holder). DOI:10.1177/1129729821997263
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 東海林 菊太郎

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