Magnetic Resonance Imaging Criteria to Predict Complete Excision of Parasellar Pituitary Macroadenoma on Postoperative Imaging

S. E. J. Connor; F. Wilson; K. Hogarth

doi:10.1055/s-0033-1353362

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2014; 75(01): 041-046
DOI: 10.1055/s-0033-1353362

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Magnetic Resonance Imaging Criteria to Predict Complete Excision of Parasellar Pituitary Macroadenoma on Postoperative Imaging

S. E. J. Connor

¹Department of Neuroradiology, King's College Hospital, London, United Kingdom

,

F. Wilson

²Department of Paediatric Radiology, Starship Children's Health, Auckland, New Zealand

,

K. Hogarth

³Department of Neuroradiology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headley Way, Headington, Oxford, United Kingdom

› Author Affiliations

Abstract

Purpose To evaluate preoperative magnetic resonance imaging (MRI) criteria for their ability to predict the complete removal of parasellar pituitary macroadenoma on the 3-month postoperative MRI.

Methods Dedicated pre- and postoperative pituitary MRI studies were reviewed in 49 patients who had undergone transsphenoidal surgery for macroadenomas with potential unilateral parasellar involvement. Twelve preoperative MRI findings and postoperative MRI outcomes were statistically compared.

Results Depiction of the inferolateral (positive predictive value [PPV]: 0.6; negative predictive value [NPV], 0.92) and lateral (PPV: 0.65; NPV: 0.85) compartments of the cavernous sinus and the percentage of intracavernous carotid artery encasement (PPV: 0.63; NPV, 1.0 for <50% encasement) were the only criteria significantly predictive of parasellar tumor complete resection. The odds ratios indicated that depiction of the lateral venous or inferolateral venous compartments increased the likelihood of a complete resection by 6 times, whereas for every 25% reduction in intracavernous carotid artery encasement, the chance of a complete resection increased 3.4 times.

Conclusion The preoperative MR imaging features that are useful in predicting the complete removal of the parasellar component of a pituitary adenoma as assessed by postoperative MRI are (1) depiction of the lateral and inferolateral compartment of the cavernous sinus and (2) decreasing encasement of the intracavernous carotid artery.

Keywords

magnetic resonance imaging - pituitary - macroadenoma - postoperative

Full Text

References

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