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Updated: Feb 15, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

19.9K

Diagnostic value of early postoperative MRI and diffusion-weighted imaging following trans-sphenoidal resection of

H A Hassan1, M A Bessar1, I R Herzallah2

  • 1Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Egypt.

Clinical Radiology
|January 14, 2018
PubMed
Abstract

Insights

Early diffusion-weighted imaging (DWI) is more effective than standard MRI in distinguishing residual pituitary adenoma from surgical changes after trans-sphenoidal resection. This advanced imaging technique aids in accurate postoperative assessment and patient management.

Area of Science:

  • Neurosurgery
  • Radiology
  • Oncology

Background:

  • Pituitary adenomas are common tumors requiring surgical intervention.
  • Differentiating residual adenoma from postoperative changes is crucial for patient management.
  • Early assessment aids in planning further treatment or follow-up.

Purpose of the Study:

  • To evaluate the efficacy of early contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in differentiating residual pituitary adenoma from postoperative surgical changes.
  • To compare the diagnostic performance of MRI and DWI in this context.

Main Methods:

  • Prospective study of 30 patients with non-functioning pituitary macroadenomas undergoing trans-sphenoidal adenomectomy.
  • Patients underwent MRI and DWI in the early postoperative period and at 6 months.
  • Apparent diffusion coefficient (ADC) values were calculated for regions of interest.

Main Results:

  • Seventeen patients had granulation tissue, and 13 had residual adenoma at 6 months.
  • Mean ADC values for granulation tissue and residual adenoma were significantly different at both early and 6-month follow-up (p<0.001).
  • Early DWI demonstrated higher sensitivity (91%) and specificity (97%) compared to early MRI (84.6% and 94.1%) for differentiating residual adenoma.

Conclusions:

  • Early postoperative DWI is a valuable tool for differentiating residual pituitary adenoma from surgical changes.
  • DWI offers superior diagnostic performance compared to early contrast-enhanced MRI in this clinical scenario.
  • This finding can improve postoperative management strategies for pituitary adenoma patients.

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