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Comparison of computerized tomography and magnetic resonance imaging for the examination of the pituitary gland in patients with Cushing's disease
Author(s) -
Escourolle H.,
Abecassis J. P.,
Bertagna X.,
Guilhaume B.,
Pariente D.,
Derome P.,
Bonnin A.,
Luton J. P.
Publication year - 1993
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/j.1365-2265.1993.tb02370.x
Subject(s) - medicine , magnetic resonance imaging , cushing's disease , coronal plane , pituitary adenoma , radiology , adenoma , pituitary gland , tomography , pituitary neoplasm , nuclear medicine , pathology , disease , hormone
Summary OBJECTIVE The vast majority of patients with Cushing's disease have a corticotroph adenoma, the selective removal of which, through the transsphenoidal route, has the potential to offer a definitive and complete cure. This study was designed to compare the diagnostic accuracy of computerized tomography (CT) and magnetic resonance imaging (MRI) to identify the presence, evaluate the size, and assess the topographic characteristics of pituitary corticotroph adenomas. METHODS Forty‐two patients with Cushing's disease were included in this prospective study, of whom 16 were subsequently explored transsphenoidally. Computerized tomography used a CE12000 CGR apparatus with 1 5‐mm coronal slices and a 2‐mm interslice gap. Magnetic resonance imaging used an MR Max 0 5T GE apparatus; adjacent 3‐mm slices were obtained with a T 1 ‐weighted gradient echo before and after gadolinium injection. RESULTS Lesions compatible with an adenoma were identified in 29 patients by MRI and in 21 patients by CT (69 vs 50%, P < 0 02). Seven macroadenomas were identified as well by the two methods. Eight of the 22 microadenomas detected by MRI were not identified by CT. Evidence for intracavernous tumour extension was found in nine patients: it was more frequently detected by MRI (8 patients) than by CT (4 patients). Fourteen patients with positive MRI had a pituitary examination: in one case the adenoma could not be reached because of purely suprasellar location; of the other 13 all were found by the surgeon and the surgical outcome was successful in 12 cases. CONCLUSION MRI is superior to CTfor the examination of the pituitary gland in patients with Cushing's disease.