Cavernous sinus invasion by pituitary macroadenomas: neuroradiological, clinical and surgical correlation
| Autor: | Arthur Cukiert, Bernardo Liberman, Mirta Knoepfelmacher, Luis R. Salgado, Mario Sergio Duarte Andrioli, Fernando Pimentel, Jayme Goldman, Marcia Nery |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 1998 |
| Předmět: |
medicine.medical_specialty
Carotid arteries cavernous sinus invasion lcsh:RC321-571 pituitary tumors medicine Humans Pituitary Neoplasms Prolactinoma lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Cushing Syndrome Sinus (anatomy) magnetic resonance image medicine.diagnostic_test business.industry Pituitary tumors Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging ressonância magnética Surgery Ring enhancement medicine.anatomical_structure Neurology Medial wall Cavernous sinus Acromegaly Cavernous Sinus Neurology (clinical) Radiology tumor hipofisário business seio cavernoso invasão Carotid syphon |
| Zdroj: | Arquivos de Neuro-Psiquiatria, Volume: 56, Issue: 1, Pages: 107-110, Published: MAR 1998 Arquivos de Neuro-Psiquiatria, Vol 56, Iss 1, Pp 107-110 (1998) Arquivos de Neuro-Psiquiatria v.56 n.1 1998 Arquivos de neuro-psiquiatria Academia Brasileira de Neurologia instacron:ABNEURO |
| Popis: | The classical imaging gold-standard for this diagnosis is the presence of tumor lateral to the carotid artery. Seventeen patients with pituitary macroadenomas with intraoperative confirmation of cavernous sinus invasion were studied with MRI. Only 8 patients had tumor lateral to the carotid artery; 13 had tumor within the carotid syphon and all lacked the ring enhancement of the medial wall of the cavernous sinus. In 10 patients, widening of the posterior double leaflets of the cavernous sinus could be. All patients were operated by the transesphenoidal route. Only one patient was cured by surgery alone. Only 3 patients disclosing the above mentioned MRI features were identified in a series of 250 patients and did not have cavernous sinus invasion. The present criteria proved to be useful in the pre-operative diagnosis of cavenous sinus invasion and patients' counselling. Pre-operative diagnosis of cavernous sinus invasion of pituitary tumors has a great impact in the management of such patients. O critério imagenológico clássico para diagnóstico de invasão de seio cavernoso é a presença de tumor lateralmente à carótida em cortes coronais. Estudamos 17 pacientes com macroadenomas hipofisários com ressonância compátivel a invasão de seio cavernoso e que tiveram esta invasão confirmada cirurgicamente. Somente 8 destes pacientes possuíam tumor lateralmente à carótida (critério clássico). Treze pacientes possuíam tumor localizado entre as porções intracavernosas da carótida e em todos havia ruptura da captação anelar de contraste no seio cavernoso. Dez pacientes possuíam abertura dos folhetos posteriores do seio cavernoso. Todos os pacientes foram tratados por via transesfenoidal. Somente um caso obteve cura endocrinológica. Somente 3 pacientes portadores de algum destes sinais imagenológicos foram identificados em uma série de cerca de 250 casos e não possuíam invasão de seio cavernoso. Os critérios acima parecem adequadamente permitir prever a invasão do seio. Este diagnóstico é relevante já que a maioria dos pacientes com invasão de seio cavernoso acaba realizando terapia complementar. |
| Databáze: | OpenAIRE |
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