Geometric survey on magnetic resonance imaging of growth hormone producing pituitary adenoma

There are previous reports investigating effectiveness of intraoperative magnetic resonance imaging (IO-MRI) in pituitary adenoma surgery but there is no clear data in the literature recommending when there is no need of intraoperative scan. This retrospective analysis was based on determining which patients does not need any IO-MRI scan following endoscopic endonasal pituitary adenoma surgery. Patients with functional or non-functional pituitary adenomas that were operated via endoscopic endonasal approach (EEA) between June 2017 and May 2019 were enrolled. Patients younger than 18 years old, patients who did not underwent IO-MRI procedure or not operated via EEA were excluded from the study. Hence, this study is designed to clarify if IO-MRI is useful in both functional and non-functional pituitary adenomas, functional adenomas did not split into subgroups. A total of 200 patients treated with pituitary adenoma were included. In Knosp Grade 0 – 2 group, primary surgeon’s opinion and IO-MRI findings were compatible in 150 patients (98.6%). In Knosp Grade 3 – 4 correct prediction were performed in 32 (66.6%) patients. When incorrectly predicted Knosp Grade 3 – 4 patients (n = 16) was analyzed, in 13 patients there were still residual tumor in cavernous sinus and in 3 patients there were no residual tumor. Fisher’s exact test showed there is a statistically significant difference of correct prediction between two different Knosp Grade groups (two-tailed P < 0.0001). Eighteen patients had a residual tumor extending to the suprasellar and parasellar regions which second most common site for residual tumor. Our findings demonstrate that there is no need of IO-MRI scan while operating adenomas limited in the sellae and not invading the cavernous sinus. However, we strongly recommend IO-MRI if there is any suprasellar and parasellar extension and/or cavernous sinus invasion.

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Diagnosis of concomitant pituitary adenoma and Rathke's cleft cyst with magnetic resonance imaging

International Journal of Surgery ◽

10.1016/j.ijsu.2015.05.001 ◽

2015 ◽

Vol 18 ◽

pp. 191-195 ◽

Cited By ~ 7

Author(s):

Shun-yuan Guo ◽

Xue-qiang Cai ◽

Jie Ma ◽

Wei-yu Wang ◽

Gang Lu

Keyword(s):

Magnetic Resonance Imaging ◽

Pituitary Adenoma ◽

Magnetic Resonance ◽

Rathke’S Cleft Cyst ◽

Resonance Imaging ◽

Rathke's Cleft Cyst ◽

Rathke's Cleft

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Radiation Necrosis of the Optic Chiasm, Optic Tract, Hypothalamus, and Upper Pons after Radiotherapy for Pituitary Adenoma, Detected by Gadolinium-Enhanced, T1-Weighted Magnetic Resonance Imaging: Case Report

Neurosurgery ◽

10.1227/00006123-199010000-00025 ◽

1990 ◽

Vol 27 (4) ◽

pp. 640-643 ◽

Cited By ~ 16

Author(s):

Osamu Tachibana ◽

Narihito Yamaguchi ◽

Tetsumori Yamashima ◽

Junkoh Yamashita

Keyword(s):

Magnetic Resonance Imaging ◽

Pituitary Adenoma ◽

Magnetic Resonance ◽

Radiation Necrosis ◽

Optic Tract ◽

Optic Chiasm ◽

Magnetic Resonance Imaging Scan ◽

Resonance Imaging ◽

Weighted Magnetic Resonance Imaging ◽

Resonance Imaging Scan

Abstract A 26-year-old woman was treated for a prolactin secreting pituitary adenoma by surgery and radiotherapy (5860 rads). Fourteen months later, she developed right hemiparesis and dysarthria. A T1-weighted magnetic resonance imaging scan using gadolinium contrast showed a small, enhanced lesion in the upper pons. Seven months later, she had a sudden onset of loss of vision, and radiation optic neuropathy was diagnosed. A T1-weighted magnetic resonance imaging scan showed widespread gadolinium-enhanced lesions in the optic chiasm, optic tract, and hypothalamus. Magnetic resonance imaging is indispensable for the early diagnosis of radiation necrosis, which is not visualized by radiography or computed tomography.

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