不同定位方法在异位ACTH综合征诊断中的应用

Application of different localization methods in diagnosis of ectopic ACTH syndrome

摘要: 目的研究不同定位方法在异位促肾上腺皮质激素(ACTH)综合征诊断中的应用。方法回顾性分析我院2000-2010年确诊的20例异位ACTH综合征患者的临床资料。结果 ⑴8例行BIPSS,7例IPS/P<2、1例IPS/P>2,假阳性率为12.5%;⑵15例通过胸片、胸腹部CT等常规检查发现原发病灶;⑶8例根据不同部位外周静脉血ACTH水平帮助定位,阳性率低。结论双侧岩下窦静脉取血(BIPSS)IPS/P>2不能完全除外异位ACTH综合征;胸片、胸腹部CT能发现大多数原发病灶;外周静脉分段取血测定ACTH水平对定位诊断帮助不大,应综合各项检查手段的优势以提高异位ACTH综合征定位诊断的阳性率。

Abstract: Objective To study the application of different localization methods in diagnosis of ectopic ACTH syndrome.Methods Clinical data about 20 patients with ectopic ACTH syndrome admitted to our hospital from 2000 to 2010 were retrospectively analyzed.Results The IPS/P＞2 in bilateral petrosal sinus sample（BIPSS） could not absolutely rule out the diagnosis of ectopic ACTH syndrome.Most primary lesions could be detected by chest film and CT scan.The ACTH level measured in peripheral vein sample was not of great help for the diagnosis of ectopic ACTH syndrome.Conclusion Diagnosis of primary ectopic ACTH syndrome is quite difficult,which requires the combination of multiple imaging methods.