open access

Vol 51, No 1 (2017)
Original research articles
Submitted: 2016-02-10
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Magnetic resonance imaging and histology correlation in Cushing's disease

Václav Masopust, David Netuka, Vladimír Beneš, Martin Májovský, Tomáš Belšán, Ondřej Bradáč, Daniel Hořínek, Mikuláš Kosák, Václav Hána, Michal Kršek
DOI: 10.1016/j.pjnns.2016.10.005
·
Neurol Neurochir Pol 2017;51(1):45-52.

open access

Vol 51, No 1 (2017)
Original research articles
Submitted: 2016-02-10

Abstract

Introduction

We continuously look for new techniques to improve the radicality of resection and to eliminate the negative effects of surgery. One of the methods that has been implemented in the perioperative management of Cushing's disease was the combination of three magnetic resonance imaging (MRI) sequences: SE, SPGR and fSPGR.

Material and methods

We enrolled 41 patients (11 males, 30 females) diagnosed with Cushing's disease. A 3D tumour model with a navigation console was developed using each SPGR, fSPGR and SE sequence. The largest model was then used. In all cases, a standard four-handed, bi-nostril endoscopic endonasal technique was used. Endocrinological follow-up evaluation using morning cortisol sampling was performed for 6–34 months in our study.

Results

In total, 36 patients (88%) were disease-free following surgery. Our results indicate we achieved 100% sensitivity of MR. Overall, the conformity of at least one donor site, as compared with the places designated on MR, was in 78% of patients. We searched the place of compliance in individual locations. There is a consensus in individual locations in 63 of the 123 cases (or 56%). The correlation gamma function at a 5% significance level was then 0.27.

Discussion

The combination of MR sequences (SE, SPGR, fSPGR), neuronavigation system and iMRI led to increased sensitivity of up to 100%. Specificity reached 56% in our study.

Conclusion

We found a high success rate in surgical procedure in terms of the correlation between MR findings and histology, which leads to remission of Cushing's disease.

Abstract

Introduction

We continuously look for new techniques to improve the radicality of resection and to eliminate the negative effects of surgery. One of the methods that has been implemented in the perioperative management of Cushing's disease was the combination of three magnetic resonance imaging (MRI) sequences: SE, SPGR and fSPGR.

Material and methods

We enrolled 41 patients (11 males, 30 females) diagnosed with Cushing's disease. A 3D tumour model with a navigation console was developed using each SPGR, fSPGR and SE sequence. The largest model was then used. In all cases, a standard four-handed, bi-nostril endoscopic endonasal technique was used. Endocrinological follow-up evaluation using morning cortisol sampling was performed for 6–34 months in our study.

Results

In total, 36 patients (88%) were disease-free following surgery. Our results indicate we achieved 100% sensitivity of MR. Overall, the conformity of at least one donor site, as compared with the places designated on MR, was in 78% of patients. We searched the place of compliance in individual locations. There is a consensus in individual locations in 63 of the 123 cases (or 56%). The correlation gamma function at a 5% significance level was then 0.27.

Discussion

The combination of MR sequences (SE, SPGR, fSPGR), neuronavigation system and iMRI led to increased sensitivity of up to 100%. Specificity reached 56% in our study.

Conclusion

We found a high success rate in surgical procedure in terms of the correlation between MR findings and histology, which leads to remission of Cushing's disease.

Get Citation

Keywords

Pituitary adenoma, Endoscopic resection, Magnetic resonance imaging

About this article
Title

Magnetic resonance imaging and histology correlation in Cushing's disease

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 1 (2017)

Pages

45-52

DOI

10.1016/j.pjnns.2016.10.005

Bibliographic record

Neurol Neurochir Pol 2017;51(1):45-52.

Keywords

Pituitary adenoma
Endoscopic resection
Magnetic resonance imaging

Authors

Václav Masopust
David Netuka
Vladimír Beneš
Martin Májovský
Tomáš Belšán
Ondřej Bradáč
Daniel Hořínek
Mikuláš Kosák
Václav Hána
Michal Kršek

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