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[CT after transsphenoidal surgery]
1Department of Radiology, Tohoku University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. Nippon Acta Radiologica
|March 25, 1991
Summary
Computed tomography (CT) helps monitor patients after transsphenoidal surgery. Early CT scans show common postoperative changes, but residual tumors are best identified by diaphragm changes after 3 months.
Area of Science:
- Neurosurgery
- Radiology
- Endocrinology
Background:
- Transsphenoidal surgery is a common procedure for pituitary tumors.
- Postoperative imaging is crucial for evaluating treatment efficacy and detecting recurrence.
- Differentiating between normal postoperative changes and residual tumor can be challenging.
Purpose of the Study:
- To evaluate the utility of computed tomography (CT) in assessing patients following transsphenoidal surgery.
- To identify CT findings indicative of residual or recurrent functioning pituitary tumors.
- To establish optimal follow-up imaging protocols.
Main Methods:
- Retrospective review of 210 CT studies from 95 patients who underwent transsphenoidal surgery.
- Correlation of CT findings with hormonal assessments and clinical outcomes.
- Analysis of imaging changes over time, including opacification, hematoma, gas, bone defects, and diaphragm morphology.
Main Results:
- Common early CT findings (within 2 weeks) include spheno-ethmoid opacification, intrasellar hematoma, and gas bubbles.
- Bone defects and stents are frequently observed.
- Upward convexity of the diaphragma sellae after 3 months is a potential indicator of residual tumor.
- Recurrence was observed in 6% of patients, detected on long-term follow-up CT.
Conclusions:
- CT is valuable for monitoring transsphenoidal surgery outcomes.
- Initial follow-up CT at 3 months is recommended to allow inflammatory changes to resolve.
- Long-term, annual or biennial CT scans, combined with clinical and hormonal data, are necessary for detecting recurrence.