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Related Experiment Videos

Cushing's disease: pituitary imaging

S Tripathi1, A C Ammini, R Bhatia

  • 1Department of Endocrinology, All India Institute of Medical Sciences, New Delhi.

Australasian Radiology
|August 1, 1994
PubMed
Summary
This summary is machine-generated.

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Magnetic resonance imaging (MRI) with gadolinium enhancement is crucial for diagnosing pituitary adenomas in patients with adrenocorticotropic hormone (ACTH)-dependent hypercortisolism, improving detection rates compared to CT scans.

Area of Science:

  • Endocrinology
  • Radiology
  • Neurosurgery

Background:

  • Adrenocorticotropic hormone (ACTH)-dependent hypercortisolism is often caused by pituitary adenomas.
  • Accurate diagnosis and localization of these pituitary adenomas are essential for effective treatment.

Purpose of the Study:

  • To evaluate the efficacy of computed axial tomography (CT) and magnetic resonance imaging (MRI) in detecting pituitary adenomas in patients with ACTH-dependent hypercortisolism.
  • To assess the added value of gadolinium diethylene triamine penta acetic acid (gd-DTPA) enhanced MRI.

Main Methods:

  • Fourteen patients with ACTH-dependent hypercortisolism underwent pituitary imaging.
  • Imaging modalities included CT and MRI, with some patients receiving gd-DTPA enhanced MRI.
  • Surgical outcomes were correlated with imaging findings.

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Main Results:

  • CT identified pituitary macroadenomas in two patients and hyperplasia in one.
  • MRI revealed macroadenomas in one, microadenomas in three, and hyperplasia in two.
  • Gd-DTPA enhanced MRI detected four additional pituitary microadenomas.
  • Surgery confirmed microadenomas in cases initially showing only pituitary enlargement.

Conclusions:

  • MRI, particularly with gd-DTPA enhancement, is superior to CT for identifying and localizing pituitary adenomas in ACTH-dependent hypercortisolism.
  • Enhanced MRI should be considered even when initial scans are normal to improve diagnostic yield.