Related Experiment Videos
Cavernous sinus invasion by pituitary adenoma: MR imaging
J P Cottier1, C Destrieux, L Brunereau
1Department of Neuroradiology, CHRU Bretonneau, 2 bis, Bd Tonnellé, 37044 Tours cedex, France. cottier@med.univ-tours.fr
Radiology
|May 5, 2000
Summary
Magnetic resonance (MR) imaging criteria can help diagnose cavernous sinus invasion by pituitary adenoma. Specific encasement percentages of the internal carotid artery (ICA) and tumor crossing certain lines indicate invasion.
Area of Science:
- Radiology
- Neuroimaging
- Oncology
Background:
- Pituitary adenomas can invade the cavernous sinus, complicating diagnosis and treatment.
- Accurate diagnosis of cavernous sinus invasion is crucial for surgical planning and patient outcomes.
Purpose of the Study:
- To establish magnetic resonance (MR) imaging criteria for diagnosing cavernous sinus invasion by pituitary adenoma.
- To improve the accuracy of MR imaging in detecting cavernous sinus invasion.
Main Methods:
- Retrospective review of MR images from 106 patients with pituitary adenoma.
- Surgical findings served as the standard for diagnosing cavernous sinus invasion.
- Statistical analysis including chi-squared tests to determine sensitivity, specificity, PPV, and NPV for various MR imaging signs.
Main Results:
- Cavernous sinus invasion was certain (100% PPV) with >=67% encasement of the internal carotid artery (ICA) by tumor.
- High probability of invasion (95% PPV) if carotid sulcus venous compartment was absent; 85% PPV if tumor crossed the line joining lateral walls of intracavernous and supracavernous ICAs.
- No invasion certain (100% NPV) with <25% ICA encasement or if tumor did not cross the line joining medial walls of intracavernous and supracavernous ICAs.
Conclusions:
- Radiologic diagnosis of cavernous sinus invasion by pituitary adenoma remains challenging.
- Defined MR imaging criteria, particularly related to ICA encasement and tumor crossing specific lines, can aid in diagnosis.