Article
Intraoperative MRI in 62 patients with pituitary adenoma
Intraoperative MRT bei 62 Patienten mit Hypophysenadenomen
Search Medline for
Authors
Published: | April 23, 2004 |
---|
Outline
Text
Objective
To evaluate intraoperative high-field MRI in patients with pituitary adenoma, especially to analyse shift of the carotid arteries during surgery.
Methods
An OR integrated 1.5T Magnetom Sonata (Siemens Medical Solutions) high field MR-scanner was used to aquire pre- and intraoperative image data from patients with pituitary adenoma undergoing a transsphenoidal adenoma resection by the senior author. T1, later in the study T2 weighted sequences were applied before and during surgical resection. Additional T2 weighted HASTE sequences were used for a fast image aquisition and first assessment.
Results
Between April 2002 and July 2003, 62 patients with pituitary adenoma, especially adenomas with a relevant supra- or parasellar part, underwent intraoperative high-field MRI. In 37 cases there was no relevance of the intraoperative imaging because of primarily complete resection of the tumor or an incomplete resection without the possibility of further operation, for example because of invasion of the cavernous sinus. In 17 cases MRI was highly relevant leading to the completion of resection by performing a second look and further tumor resection. In 8 cases it was possible to extend the resection, but not to complete it. Shift of carotid arteries was seen only in 2 patients, whereas expansion of the cavernous sinus is a frequently observed occurence.
Conclusions
The use of intraoperative MRI in transsphenoidal operation of patients with pituitary adenoma improves the extent of tumor resection and the number of completely resected tumors. Shift of carotid arteries even in large adenomas is a rarely seen occurence.