2017年6月22日 · The purpose of this article is to review the clinical features and diagnosis of CS, the imaging localization of the source of hypercortisolism, and the management of CS.

2017年6月22日 · Cushing syndrome (CS) is a constellation of clinical signs and symptoms resulting from chronic exposure to excess cortisol, either exogenous or endogenous. Exogenous CS is most commonly caused by administration of glucocorticoids. Endogenous CS is subdivided into two types: adrenocorticotropic hormone (ACTH) dependent and ACTH independent.

2023年7月4日 · Targeted imaging using CT scans, MRI, PET imaging, and specialized nuclear medicine imaging, including Octreotide scintigraphy and Gallium-68 DOTATATE imaging, is complementary. As most EcCS lesions are found in the chest, chest based imaging may be the best place to begin in the absence of clinical clues from the history and physical examination.

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.

2024年8月29日 · Measuring cortisol typically needs to be over a 24-hour period because release is intermittent. Imaging of the suspected region is then required: If ACTH is elevated but no microadenoma can be identified, and no ectopic source can be found, then inferior petrosal sinus sampling can be undertaken.

Nonneoplastic hypercortisolism (formerly known as pseudo-Cushing syndrome) has been recognized for more than 50 years and often causes diagnostic uncertainty.

This systematic review gathers evidence that helps to clarify the efficacy of nuclear medicine imaging techniques most frequently used for the diagnosis of ECS sources, highlighting their advantages and limitations compared to conventional cross-sectional imaging.

2022年6月9日 · Cushing’s disease (CD) is among the most common etiologies of hypercortisolism. Magnetic resonance imaging (MRI) is often utilized in the diagnosis of CD, however, up to 64% of adrenocorticotropic hormone (ACTH)-producing pituitary microadenomas are undetectable on MRI.

2022年1月1日 · Clinical suspicion of endogenous hypercortisolism leads to screening with laboratory testing. Validated tests include the 24-hour urine-free cortisol, the low-dose dexamethasone suppression test, or the late-night salivary-free cortisol.

Advances in imaging technologies, such as computed tomography and magnetic resonance imaging, have led to the detection of more incidental adrenal tumors, up to 50% of which are associated with autonomous corti-sol secretion.6 These findings enhance the understanding of the disease and its prevalence, which is higher than previ-ously thought.7.