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库辛病和负MRI:一个单中心系列,系统文献综述和元分析

Francesca Ghidoni^1,2, Alba Madoglio^1,2, Sabrina Chiloiro^3,4

¹Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.

Neurosurgical review

|February 24, 2026

概括

在MRI上没有可见的垂体瘤的库辛病 (CD) 与具有可见瘤的人相比,手术缓解率较低 (70%). 在这些具有挑战性的病例中,ACTH增生可能导致治疗失败.

科学领域:

内分泌学在内分泌学.
神经外科神经外科
在瘤学瘤学.

背景情况:

库辛病 (CD) 带来了诊断和治疗方面的挑战,特别是当垂体磁共振成像 (MRI) 对神经内分泌瘤 (PitNET) 呈阴性结果时.
手术管理是CD的主要治疗方法,但在MRI检测结果负的患者中,结果需要进一步调查.

研究的目的:

通过文献综述和元分析,系统地分析MRI阴性CD患者的手术结果.
为呈现一个新的单中心系列的内镜下垂体探索MRI阴性CD.

主要方法:

对PubMed,Scopus和Cochrane数据库 (2000-2024) 的系统审查和元分析.
对21名MRI阴性CD患者进行内镜下垂体探索 (2014-2021) 的回顾性分析.
在MRI阴性和MRI阳性CD患者之间缓解率的比较.

主要成果:

对35项研究的元分析显示,MRI阴性CD的平均手术缓解率为70%,明显低于MRI阳性CD的82%.
在整个研究中,ACTH增生症在19.6%的患者中被发现,而在机构系列中,这一比例为45%.
在机构系列中,15/22名患者实现了缓解,与组织学相关;下层状鼻采样仅有33%的预测性.

结论:

大约30%的MRI阴性CD患者无法实现手术缓解,可能是由于ACTH增生.
内镜下垂体探索提供了关键的组织学数据,并且仍然有效地管理MRI阴性CD.
建议进行多中心,前性研究,以进一步阐明结果并优化治疗策略.

关键词:

在ACTH增生症.库辛氏病是因为库辛氏病.过高皮质醇主义 (hypercortisolism) 是一种超高皮质醇主义.核磁共振阴性核磁共振阴性这是一个PitNET,一个PitNET.脑下垂体的探索

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