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Use of high-field intraoperative magnetic resonance imaging during endoscopic transsphenoidal surgery for functioning pituitary microadenomas and small adenomas located in the intrasellar region.
- Source :
-
Neurologia medico-chirurgica [Neurol Med Chir (Tokyo)] 2013; Vol. 53 (7), pp. 501-10. - Publication Year :
- 2013
-
Abstract
- The usefulness of 1.5-T high-field intraoperative magnetic resonance (iMR) imaging during transsphenoidal surgery for functioning pituitary adenomas was retrospectively evaluated based on long-term endocrine remission from the records of 14 patients who underwent transsphenoidal surgery with iMR imaging for functioning pituitary microadenomas and small adenomas located in the intrasellar region. The maximum tumor diameter was 9.3 ± 2.6 mm. Patients were diagnosed with acromegaly (n = 7), prolactinoma (n = 4), and Cushing's disease (n = 3). If iMR imaging detected tumor remnants after resection, the resection cavity was reexamined and further resection was performed. Postoperative endocrine follow-up period was mean 33.7 ± 13.3 months. Tumor remnants were detected after the first resection in seven patients. Further resection was performed in five of these patients, and three achieved long-term endocrine remission. As a result, the overall long-term endocrine remission rate was 78.5% (11/14), instead of the 57.1% (8/14) that would be expected if iMR imaging had not been performed. Long-term endocrine remission had a tendency to be associated with the absence of tumor remnants on the final iMR images, but this was not significant (p = 0.09). Long-term endocrine remission was associated with presence of tumor remnants in the cavernous sinus on the final iMR images (p = 0.03). High-field iMR imaging is useful for depicting tumor remnants after resection, and increased the long-term endocrine remission rate for patients with functioning pituitary microadenomas and small adenomas.
- Subjects :
- Adenoma diagnosis
Adult
Female
Growth Hormone-Secreting Pituitary Adenoma surgery
Humans
Male
Middle Aged
Neoplasm, Residual diagnosis
Neoplasm, Residual surgery
Pituitary ACTH Hypersecretion surgery
Pituitary Neoplasms diagnosis
Prolactinoma surgery
Reoperation
Sella Turcica surgery
Adenoma surgery
Endoscopy methods
Image Interpretation, Computer-Assisted methods
Magnetic Resonance Imaging methods
Pituitary Neoplasms surgery
Sphenoid Sinus surgery
Surgery, Computer-Assisted methods
Subjects
Details
- Language :
- English
- ISSN :
- 1349-8029
- Volume :
- 53
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Neurologia medico-chirurgica
- Publication Type :
- Academic Journal
- Accession number :
- 23883562
- Full Text :
- https://doi.org/10.2176/nmc.53.501