J L Doppman1, Z Ram, T H Shawker, E H Oldfield. 1. Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892.
Abstract
PURPOSE: To evaluate the use of ultrasound (US) of the pituitary gland during transsphenoidal surgery as a means of detecting microadenomas in patients with Cushing disease. MATERIALS AND METHODS: Thirteen patients with Cushing disease and one with acromegaly underwent US during transsphenoidal surgery. Mechanically oscillating transducers (10 MHz [n = 8] or 15 MHz [n = 6]) mounted on a 15-cm-long probe were used. RESULTS: Seven adenomas were definitely visualized, two were poorly seen, and four were overlooked. Small tumors (< 5 mm in diameter) tended to be hypoechoic; larger ones, hyperechoic. All four overlooked adenomas were imaged with the 15-MHz transducer. The cavernous sinuses and internal carotid arteries could be seen, but minimal invasion of the medial wall of the cavernous sinus could not. CONCLUSION: Pituitary microadenomas can be detected with transsphenoidal US; however, evaluation of larger series with instrumentation developed specifically for transsphenoidal application will be necessary to determine the ultimate value of this technique.
PURPOSE: To evaluate the use of ultrasound (US) of the pituitary gland during transsphenoidal surgery as a means of detecting microadenomas in patients with Cushing disease. MATERIALS AND METHODS: Thirteen patients with Cushing disease and one with acromegaly underwent US during transsphenoidal surgery. Mechanically oscillating transducers (10 MHz [n = 8] or 15 MHz [n = 6]) mounted on a 15-cm-long probe were used. RESULTS: Seven adenomas were definitely visualized, two were poorly seen, and four were overlooked. Small tumors (< 5 mm in diameter) tended to be hypoechoic; larger ones, hyperechoic. All four overlooked adenomas were imaged with the 15-MHz transducer. The cavernous sinuses and internal carotid arteries could be seen, but minimal invasion of the medial wall of the cavernous sinus could not. CONCLUSION:Pituitary microadenomas can be detected with transsphenoidal US; however, evaluation of larger series with instrumentation developed specifically for transsphenoidal application will be necessary to determine the ultimate value of this technique.
Authors: Prashant Chittiboina; S Lalith Talagala; Hellmut Merkle; Joelle E Sarlls; Blake K Montgomery; Martin G Piazza; Gretchen Scott; Abhik Ray-Chaudhury; Russell R Lonser; Edward H Oldfield; Alan P Koretsky; John A Butman Journal: J Neurosurg Date: 2016-03-18 Impact factor: 5.115