Premium
Silent, but not unseen: multimicrocystic aspect on T 2‐weighted MRI in silent corticotroph adenomas
Author(s) -
Cazabat Laure,
Dupuy Martin,
Boulin Anne,
Bernier Michèle,
Baussart Bertrand,
Foubert Luc,
RaffinSanson MarieLaure,
Caron Philippe,
Bertherat Jérôme,
Gaillard Stéphan
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12443
Subject(s) - corticotropic cell , medicine , endocrinology , adenoma , neuroscience , psychology , pituitary gland , hormone
Summary Objective Silent corticotroph adenomas ( SCA s) present as nonfunctional pituitary tumours in routine pre‐operative evaluation. The objective of this study was to evaluate the diagnostic accuracy of MRI T 2‐weighted sequences for detecting the corticotroph subtype pre‐operatively. Design The pre‐operative T 2‐weighted MRI sequences were retrospectively evaluated in patients with SCA and two control groups: clinically manifest corticotroph macroadenomas ( CSM s) and nonfunctional gonadotroph macroadenomas ( NFGM s). All were selected from a registry of 1096 patients in whom transsphenoidal surgery was performed in the same tertiary reference centre. T 2‐weighted MRI sequences were independently classified by one senior endocrinologist and one senior radiologist who were blinded to the clinical and histological features. Patients Seventeen patients with SCA , 14 with CSM and 60 with NFGM were included in this study. Measurements Pituitary MRI with T2‐weighted sequences. Two aspects were retained: multiple microcysts ( MM s) and the absence of microcysts. Hormonal data included plasma prolactin, IGF ‐1, testosterone or oestradiol, LH , FT 4, TSH , morning plasma cortisol and an ACTH ‐stimulation test, when available. Results Multiple microcysts were present in 76% (13/17) of SCA s, 21% (3/14) of CSM s and 5% (3/60) of NFGM s. The presence of MM s in clinically nonfunctioning macroadenomas had a sensitivity of 76% and a specificity of 95% for predicting SCA . Conclusion The presence of MM s in T 2‐weighted MRI is a good diagnostic tool to suggest the corticotroph subtype in an apparently nonfunctional pituitary tumour.