Volume 2 Issue 3
Jul.  2011
Turn off MathJax
Article Contents
Ming-li LI, Jian ZHANG, Yang LIU, Zheng-yu JIN. Magnetic Resonance Imaging of Sella after Transsphenoidal Resection of Pituitary Macroadenoma[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(3): 222-226. doi: 10.3969/j.issn.1674-9081.2011.03.007
Citation: Ming-li LI, Jian ZHANG, Yang LIU, Zheng-yu JIN. Magnetic Resonance Imaging of Sella after Transsphenoidal Resection of Pituitary Macroadenoma[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(3): 222-226. doi: 10.3969/j.issn.1674-9081.2011.03.007

Magnetic Resonance Imaging of Sella after Transsphenoidal Resection of Pituitary Macroadenoma

doi: 10.3969/j.issn.1674-9081.2011.03.007
More Information
  • Corresponding author: LI Ming-li Tel: 010-65295469, E-mail:pumclml@126.com
  • Received Date: 2011-04-25
  • Publish Date: 2011-07-30
  •   Objective  To summarize the magnetic resonance imaging (MRI) features of sella after transsphenoidal resection of pituitary macroadenoma, and explore the rational opportunities for the first radiological follow-up.  Methods  The clinical data and preoperative and postoperative MRI of 40 patients with macroadenoma were retrospectively analysed. The postoperative MRI was performed at early period (within 1 week), medium period (about 3 month), or later period (after 6 months or 1 year).  Results  Patients were divided into two groups based on preoperative data:invasive macroadenoma group (n=16) and noninvasive macroadenoma group (n=24). Residual tumors (n=11) were only found in the invasive macroadenoma group during the radiological follow-up. During the early period of postoperative follow-up, pituitary mass can still be found in soft tissue, with the heights decreased in varying degrees compared with those of the preoperative mass. The implanted material showed no enhancement on post-contrast MRI. The residural tumors showed mild to middle enhancement, while the residual pituitary gland showed apperent enhancement. During the medium period of postoperative follow-up, the implanted material was obviously or completely absorbed; the pituitary glands often collapsed, while the residual pituitary glands showed remarked enhancement. The re-expansion of the gland was found in some cases. The residural tumors were shown clearly, and the visibility of these residural tumors were not apparently different from those in the early period. The MRI features in the later were similar to those in the medium period. The inflammation of sphenoid sinus were absorbed slowely, and was still present after 6 months after surgery in most cases. Tumor recurrences were found in three patients one year later after the surgury, shown as the increased residural tumors (n=2), and newly developed soft tissue (n=1).  Conclusions  The MRI features differ at different time points after transsphenoidal resection of pituitary macroadenoma. For noninvasive macroadenoma, an MRI follow-up 3 months after surgery was appropriate and sufficient. For invasive macroadenoma, however, postoperative residual tumors may be found during early-and medium-period followup.
  • loading
  • [1] Boxerman JL, Rogg JM, Donahue JE, et al. Preoperative MRI evaluation of pituitary macroadenoma:imaging features predictive of successful transsphenoidal surgery[J]. AJR, 2010, 195:720-728. doi:  10.2214/AJR.09.4128
    [2] Gutenberg A, Larsen J, Lupi I, et al. A radiologic score to distinguish autoimmune hypophysitis from nonsecreting pituitary adenoma preoperatively[J]. AJNR, 2009, 30:1766-1772. doi:  10.3174/ajnr.A1714
    [3] Yoneoka Y, Watanabe N, Matsuzawa H, et al. Preoperative depiction of cavernous sinus invasion by pituitary macroadenoma using three-dimensional anisotropy contrast periodically rotated overlapping parallel lines with enhanced reconstruction imaging on a 3-tesla system[J]. J Neurosurg, 2008, 108:37-41. doi:  10.3171/JNS/2008/108/01/0037
    [4] Tosaka M, Sato N, Hirato J, et al. Assessment of hemorrhage in pituitary macroadenoma by T2* -weighted gradientecho MR imaging[J]. AJNR, 2007, 28:2023-2029. doi:  10.3174/ajnr.A0692
    [5] Tokumaru AM, Sakata I, Terada H, et al. Optic nerve hyperintensity on T2-weighted images among patients with pituitary macroadenoma:correlation with visual impairment[J]. AJNR, 2006, 27:250-254. http://www.ncbi.nlm.nih.gov/pubmed/16484385
    [6] Knosp E, Steiner E, Kits K, et al. Pituitary adenomas with invasion of the cavernous sinus space:a magnetic resonace imaging classification compared with surgical findings[J]. Neurosurgery, 1993, 33:610-617. http://www.ncbi.nlm.nih.gov/pubmed/8232800
    [7] Yoon PH, Kim DI, Jeon P, et al. Pituitary adenomas:early postoperative MR imaging after transsphenoidal resection[J]. AJNR, 2001, 22:1097-1104. http://europepmc.org/abstract/MED/11415904
    [8] Kremer P, Forsting M, Ranaei G. Magnetic resonance imaging after transsphenoidal surgery of clinically non-functional pituitary macroadenomas and its impact on detecting residual adenoma[J]. Acta Neurochir (Wien), 2002, 144:433-443. doi:  10.1007/s007010200064
    [9] 林富禄, 岳志健, 周晓平, 等.无功能垂体大腺瘤经蝶窦入路手术后核磁共振随访[J].临床神经外科杂志, 2004, 1:58-60. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=lcsjwkzz200402003
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(1)

    Article Metrics

    Article views (183) PDF downloads(6) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return