Radiologic assessment of pituitary microadenomas

Area of Science:

• Neurosurgery
• Radiology
• Endocrinology

Background:

• Pituitary adenomas are common tumors.
• Transsphenoidal surgery is a primary treatment.
• Accurate diagnosis is essential for effective management.

Purpose of the Study:

• To evaluate the diagnostic efficacy of plain skull radiographs versus thin-section tomography for detecting pituitary adenomas.
• To assess the ability of routine imaging to identify intrasellar masses.

Main Methods:

• Review of radiographs from 146 patients who underwent transsphenoidal pituitary adenoma removal.
• Measurement of sella area and volume on routine lateral and frontal radiographs.
• Analysis of thin-section tomograms for intrasellar abnormalities.

Main Results:

• 73 patients had normal-sized sellas on routine radiographs.
• Thin-section tomography revealed intrasellar masses in all but three of these patients.
• Pituitary microadenomas ( < 1.5 cm) can be missed with plain radiography alone.

Conclusions:

• Plain skull radiographs are insufficient for diagnosing pituitary microadenomas.
• Thin-section tomography is a more sensitive imaging modality for detecting intrasellar masses.
• Imaging technique significantly impacts the diagnosis of pituitary adenomas.