High-resolution MR imaging of pituitary microadenomas at 1.5 T: experience with Cushing disease

Peck, Wallace W.; Wp, Dillon; Norman, David; Th, Newton; Cb, Wilson

doi:10.2214/ajr.152.1.145

Cited by 94 publications

(41 citation statements)

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“…ACTH-secreting pituitary microadenoma cannot always be identified in imaging studies such as computed tomography [7,11] and MRI [7][8][9][10] studies. Moreover, pituitary adenoma is detected incidentally by MRI in 10% of healthy persons; false positivity can also occur [12].…”

Section: Discussionmentioning

confidence: 99%

“…Most patients of ACTH dependent Cushing's syndrome have adrenocorticotropic hormone (ACTH)-secreting pituitary microadenoma, but ectopic ACTH syndrome, which causes 9-18% of Cushing's syndrome [2], is sometimes responsible. Laboratory studies fail to accurately distinguish these two etiologies in 10-30% of cases [3][4][5][6], and the sensitivity of magnetic resonance imaging (MRI) for detection of ACTH-secreting pituitary microadenoma is reported to range from 54% to 91% [7][8][9][10]. Therefore, ectopic ACTH syndrome is sometimes misdiagnosed.…”

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Reduction of a Pancreatic Tumor after Total Removal of an ACTH Secreting Pituitary Tumor: Differential Diagnosis of Cushing's Syndrome

et al. 2006

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Abstract. Endocrinologic tests sometimes fail to distinguish adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma from ectopic ACTH-secreting tumor. The authors experienced a case of Cushing's disease associated with a pancreatic tumor. Venous sampling contributed to the final diagnosis of Cushing's disease in this complex case, while endocrinologic tests showed paradoxical results. A 54-year-old woman presented with Cushing's syndrome and pancreatic tumor. Magnetic resonance imaging (MRI) failed to reveal a pituitary tumor, but a gadolinium-enhanced tumor with cystic components was seen in the pancreatic tail. Results of conventional endocrinologic tests suggested ectopic ACTH syndrome, but venous sampling including cavernous sinus sampling indicated an ACTH-secreting pituitary adenoma. Transsphenoidal surgery revealed a pituitary microadenoma, and total removal of the tumor was achieved. Postoperative abdominal MRI revealed that the pancreatic tumor diminished gradually without treatment. Selective cavernous sinus sampling was useful for distinguishing ACTH-secreting pituitary adenoma from ectopic ACTH syndrome in this complex case. This was a rare case in which the pancreatic tumor diminished after total removal of the ACTHsecreting pituitary adenoma.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Reduction of a Pancreatic Tumor after Total Removal of an ACTH Secreting Pituitary Tumor: Differential Diagnosis of Cushing's Syndrome

et al. 2006

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“…Magnetic resonance imaging (MRI) of the pituitary with gadolinium enhancement currently exhibits a sensitivity of approximately 60-70% in identifying a pituitary microadenoma and should be the imaging modality of choice. 20,[97][98][99][100][101] Approximately 5% of pituitary microadenomas can take up gadolinium, becoming iso-intense with the normal pituitary in the post-contrast scans; for this reason pre-contrast scans should always be performed, where the tumour is shown as a lesion with lower intensity than the normal pituitary. 102 A recent study showed that when postcontrast spoiled gradient-recalled acquisition MRI is used in the steady-state (SPGR), it is superior to spin echo (SE) MRI and should be used in addition to conventional SE-MRI.…”

Section: Radiological Diagnosis Of Cushing's Syndromementioning

confidence: 99%

The diagnosis and differential diagnosis of endogenous Cushing?s syndrome

Makras¹,

Toloumis²,

Papadogias³

et al. 2006

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AbstrActcushing's syndrome (cs) is a physically and psychologically disabling disease associated with high morbidity resulting from inappropriate elevation of circulating free cortisol levels. the main features of cs are disturbance of the normal circadian rhythm of cortisol secretion, impairment of the normal feedback of the hypothalamo-pituitary-adrenal (HPA)-axis, and excessive integrated 24 hours cortisol secretion. All biochemical tests used for the diagnosis of cs rely upon the ascertainment of a disturbance of these features. However, the diagnosis of cs (endogenous hypercortisolism) still remains a challenge, although the evolution of several diagnostic tests has allowed diagnosis at an earlier stage. In the initial investigation of cs, tests of high sensitivity are required to identify patients at risk, which are followed by tests of high specificity to confirm the diagnosis and establish the precise aetiology. this review will discuss the various causes of endogenous cs and focus on established and evolving diagnostic procedures used for its diagnosis, as several studies with large number of patients have recently appeared in the literature validating current practice and proposing improved diagnostic algorithms.

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“…Several groups have shown that short-repetitiontime, short-echo-time SE images (i.e., T1 weighted) generate very good contrast for visualizing pituitary pathology. 2,3,4,5,6 Compared with T1-weighted images, long-repetition-time, long-echo-time SE (i.e., T2 weighted) images have been less successful in demonstrating pituitary lesions, in particular, small adenomas. 3,7 On the other hand, three-dimensional Fourier transform GE images have achieved greater success; these have been found to provide results comparable with T1-weighted SE methods.…”

Section: Introductionmentioning

confidence: 99%

Multiplanar Mri and Ct Imaging of Sellar and Parasellar Tumours With Clinical and Pathological Correlation

S¹,

P²,

A³

et al. 2016

jemds

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AIMS AND OBJECTIVES To review the anatomy of sellar and parasellar regions.  To review a systematic anatomic approach to differential diagnosis of a sellar or parasellar tumors.  To correlate the diagnosis on magnetic resonance imaging with pathological DIAGNOSIS. MATERIALS AND METHODSA Prospective study of a total of 40 consecutive patients who were referred to the department of Radiodiagnosis, Osmania General Hospital from December 2010 and September 2012 were included in the study after informed consent. RESULTSMajority of patients were between 20 to 40 years. Male preponderance was seen (Males 26, females 14). Commonest tumor encountered in our study was pituitary adenoma (65%) among which macro adenomas constituted about 50% of the cases and 15% of cases were micro adenomas. Most of the functioning adenomas were seen in females -of which prolactinoma was the commonest. CONCLUSIONMR imaging is preferred over CT for the diagnosis of pituitary adenomas because it provides multiplanar high contrast images, higher definition of small sellar lesions (Microadenomas) of the pituitary and further it improves anatomical definition of the pituitary, optic chiasma compression, cavernous sinus invasion before surgery. It is also preferred for postsurgical surveillance. CT has a complementary role in delineating bony destruction and the visualization of calcification and preoperative planning. Coronal images are the best for anatomical details of this region.

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High-resolution MR imaging of pituitary microadenomas at 1.5 T: experience with Cushing disease

Cited by 94 publications

References 0 publications

Reduction of a Pancreatic Tumor after Total Removal of an ACTH Secreting Pituitary Tumor: Differential Diagnosis of Cushing's Syndrome

Reduction of a Pancreatic Tumor after Total Removal of an ACTH Secreting Pituitary Tumor: Differential Diagnosis of Cushing's Syndrome

The diagnosis and differential diagnosis of endogenous Cushing?s syndrome

Multiplanar Mri and Ct Imaging of Sellar and Parasellar Tumours With Clinical and Pathological Correlation

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