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Quantitative volumetric analysis post transsphenoidal pituitary adenoma surgery.
MedLine Citation:
PMID:  22931700     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Computed tomogram (CT) imaging is often used for immediate postoperative assessment of transsphenoidal pituitary adenoma resection while magnetic resonance imaging (MRI) is used for follow-up. The residual mass is known to decrease in size over time but the difference between the two imaging modalities has not been quantified. Our objective was to quantify the size difference of the residual mass on immediate postoperative CT compared with delayed MRI. Methods: Retrospective analysis of 69 patients who had undergone pituitary adenoma resection at our institution between 2004-2010. Sellar and suprasellar diameter, along with the overall volume of the residual mass were measured on both the immediate postoperative CT and delayed MRI. Results: Average preoperative sellar and suprasellar diameter was 22.2 ± 4.6mm and 20.9 ± 5.9mm, respectively. Average sellar residual diameter on immediate postoperative CT (16.5 ± 5.4 mm, 25% reduction) was significantly larger than delayed MRI (10.6 ± 6.2mm, 52% reduction). The average suprasellar component on CT (15.5±6.5mm, 26% reduction) was also significantly larger than that on MRI (3.3 ± 5.4 mm, 84% reduction). The postoperative CT showed a 46% reduction in volume while a 71% reduction was noted on the delayed MRI. Conclusion: A significant reduction in residual mass is noted on delayed MR imaging compared with immediate postoperative CT. Therefore, from a resource management and prognostication point of view, CT should be used for immediate postoperative assessment while delayed MRI should be used to assess operative success and for communication with patients.
Authors:
Alireza Mansouri; Sean Symons; Michael Schwartz; Joseph Chen; Farhad Pirouzmand
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  39     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  600-4     Citation Subset:  IM    
Affiliation:
Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
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