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[Diagnosis of pituitary microadenoma by magnification carotid angiography and intercavernous sinus venography]
Abstract:
Carotid angiography was performed on 12 cases of pituitary microadenomas at 2.3 X magnified frontal projection and 3.0 X magnified lateral projection. Magnification carotid angiograms were analyzed to determine the pathologic findings in 12 cases on 23 sides. Carotid angiograms demonstrated compressed posterior pituitary gland in 3 of 12 cases and 4 of 23 sides which resulted from the expansion of pituitary microadenomas. But carotid angiogram failed to demonstrate any evidence of tumor stain, abnormal capsular arteries or hypertrophied inferior hypophyseal arteries. These results suggested that magnification carotid angiography was not a useful diagnostic procedure for the detection of pituitary microadenomas. Intercavernous sinus venography was performed on 12 cases of pituitary microadenomas. The technique consisted in catheterization into the inferior petrosal sinus after puncture of the femoral vein. Injection of 10 ml. of contrast medium into the inferior petrosal sinus at a rate of 5 ml. per second. The base projection is most demonstrable and routinely used. Intercavernous sinus venography identified the presence of microadenoma in 10 of 12 cases and false negative in two cases. Nine of 12 cases demonstrated narrowing, interruption and disappearance of the anterior and inferior intercavernous sinuses. Only 3 of 12 cases demonstrated narrowing of the posterior intercavernous sinus and nine cases demonstrated compression signs of the venous strips of the cavernous sinus.(ABSTRACT TRUNCATED AT 250 WORDS)