PMID: 3748338Jul 1, 1986Paper

Craniotomy versus transsphenoidal excision of large pituitary tumors: the usefulness of magnetic resonance imaging in guiding the operative approach

Neurosurgery
R B SnowR H Patterson

Abstract

Fifteen patients with large pituitary tumors were studied with computed tomography (CT) and magnetic resonance imaging (MRI). CT was performed using General Electric 8800 and 9800 scanners (General Electric Co., Medical Systems Division, Milwaukee, Wisconsin). MRI was performed utilizing a Technicare superconducting scanner (Technicare, Cleveland, Ohio) at 0.5 tesla. Based on the operative findings, the tumors were divided into two groups. Tumors in Group 1 (n = 12) were described by the surgeon as soft or partially necrotic and easily removed by suction and curettage. Tumors in Group 2 (n = 3) were firm and required sharp dissection or the laser for removal. The tumors were divided into four categories based on MRI signal: (a) isointense with surrounding brain on spin echo (SE) 30 and SE 90, (b) increased signal intensity on SE 30 and SE 90, (c) decreased signal intensity on SE 30 and increased signal intensity on SE 90, and (d) isointense signal on SE 30 and increased signal intensity on SE 90. All three of the firm tumors were isointense with brain on MRI appearance. The tumor consistency (firm vs. soft) was not differentiable on CT scan. The transsphenoidal approach is less satisfactory than craniotomy in cases of firm, fib...Continue Reading

Citations

Oct 19, 2012·Pituitary·Ravindran PratheeshAri G Chacko
Aug 15, 2002·Surgical Neurology·Cargill H AlleyneNelson Mobolanle Oyesiku
Aug 24, 2010·AJR. American Journal of Roentgenology·Jerrold L BoxermanCurt E Doberstein
Nov 30, 2006·British Journal of Neurosurgery·B BahuleyanA G Chacko

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