Evaluation of pituitary adenomas by multidirectional multislice dynamic CT.

Area of Science:

• Radiology
• Medical Imaging
• Neurosurgery

Background:

• Multidetector-row CT (MDCT) offers rapid scanning capabilities.
• MDCT enables multiplanar reformatted (MPR) imaging, creating multislice dynamic CT (MSDCT) datasets in various planes.

Purpose of the Study:

• To evaluate the initial results of sagittal and coronal MSDCT images reconstructed by MPR (MSDCT-MPR) in patients with pituitary adenomas.
• To assess the utility of MSDCT-MPR in surgical planning for pituitary adenomas, particularly in patients with pacemakers where MRI may be contraindicated.

Main Methods:

• Three patients with pituitary adenomas and pacemakers underwent MSDCT-MPR imaging.
• Sagittal and coronal reformatted images were analyzed for pituitary adenoma characteristics and relationship to surrounding structures.
• Surgical outcomes were correlated with preoperative MSDCT-MPR findings.

Main Results:

• MSDCT-MPR clearly depicted microadenomas as less enhanced areas compared to normal pituitary tissue.
• Macroadenomas were visualized as less enhanced or non-uniformly enhanced masses, with details on cavernous sinus invasion.
• Bone destruction and prior surgical changes in the sellar floor were accurately identified.
• Surgery, guided solely by MSDCT-MPR, confirmed the imaging findings in all patients.

Conclusions:

• MSDCT-MPR provides high-quality imaging essential for surgical planning of pituitary adenomas.
• This technique is a viable alternative to MRI for patients with pacemakers or other contraindications.
• This study represents the first report on the application of MSDCT-MPR for visualizing pituitary disorders.