PMID: 18209870Jan 23, 2008Paper

Imaging in Cushing's syndrome

Arquivos brasileiros de endocrinologia e metabologia
Anju SahdevAshley Grossman

Abstract

Once the diagnosis of Cushing's syndrome (CS) has been established, the main step is to differentiate between ACTH dependent and independent disease. In adults, 80% of CS is due to ACTH-dependent causes and 20% due to adrenal causes. ACTH-secreting neoplasms cause ACTH-dependent CS. These are usually anterior pituitary microadenomas, which result in the classic Cushing's disease. Non-pituitary ectopic sources of ACTH, such as a small-cell lung carcinoma or carcinoid tumours, are the source of the remainder of ACTH-dependent disease. In the majority of patients presenting with clinical and biochemical evidence of CS, modern non-invasive imaging can accurately and efficiently provide the cause and the nature of the underlying pathology. Imaging is essential for determining the source of ACTH in ectopic ACTH production, locating the pituitary tumours and distinguishing adrenal adenomas, carcinomas and hyperplasias. In our chapter we review the adrenal appearances in ACTH-dependent and ACTH-independent CS. We also include a discussion on the use of MRI and CT for the detection and management of pituitary ACTH secreting adenomas. CT of the chest, abdomen and pelvis with intravenous injection of contrast medium is the most sensitive ...Continue Reading

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Citations

Aug 9, 2012·Annals of Saudi Medicine·Agata Juszczak, Ashley Grossman
Jul 16, 2010·The Journal of Clinical Hypertension·Joel Handler
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Aug 5, 2017·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Hao WangZhaohui Zhu

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