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- 垂体促肾上腺皮质激素腺瘤的MRI特点和手术疗效
- 作者:幸兵|发布时间:2008-04-12|浏览量:1763次
Bing Xing*, Kan Deng, Zu-yuan Ren,et al. Magnetic Resonance Imaging Characteristics and Surgical Results of Adrenocorticotropin -secreting Pituitary Adenomas,Chin Med Sci J,2008,23(1):44-48
幸兵* 邓侃 任祖渊 等,垂体促肾上腺皮质激素腺瘤的MRI特点和手术疗效,中国医学科学杂志(英文版),2008,23(1):44-48
关键词 垂体促肾上腺皮质激素腺瘤 磁共振 诊断 治疗
Objective To evaluate magnetic resonance imaging (MRI) characteristics and surgical results of adrenocorticotropin (ACTH)-secreting pituitary adenomas.
Methods MRI characteristics and relationship between MRI positive rate and surgical results of 266 patients with pathologically confirmed Cushing’s disease were analyzed retrospectively. All patients underwent thin-section sagittal and coronal scans of the pituitary gland before and after administration of gadolinium-diethylene triaminepenta acetic acid (Gd-DTPA) on a 1.5-Tesla MRI scanner, and dynamic enhanced MRI were performed in 39 patients. All patients underwent transsphenoidal adenomectomy. Endocrinological examinations and assessment were performed.
Results Preoperative MRI revealed normal results in 41 (15.4%) cases, microadenoma in 179 (67.3%), macroadenoma in 42 (15.8%) and huge adenoma in 4 (1.5%).Pituitary apoplexy occurred in 13 (4.9%). Positive rate of ACTH-secreting adenoma was 84.6%(225/266) on MRI scans,and that of small microadenomas was 87.2%(34/39) on dynamic enhanced MRI scans.Preoperative endocrinological tests of 199 cases supported the diagnosis of typical Cushing’s disease, while the other 67 cases had atypical endocrinological results .The endocrinological cure rate, remission rate and ineffective rate were 85.7%、9.3% and 7.5% , respectively. There was no difference in the initial endocrinological cure rate between the patients with positive and normal MRI results(90% vs 87.8% , P=0.904).
Conclusions Enhanced coronal pituitary MRI is helpful for preoperative localization of ACTH-secreting pituitary microadenoma. Dynamic enhanced MRI may improve detection rate of microadenoma . There was no marked difference in the surgical results for patients with preoperative MRI results indicating presence or absence of microadenoma.
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