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MaryO

Preliminary Experience with 3-Tesla MRI and Cushing's Disease

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http://www.thieme-connect.com/ejournals/ab...5/s-2007-985196

 

TECHNICAL NOTE

Skull Base 2007; 17: 273-277

DOI: 10.1055/s-2007-985196

 

Preliminary Experience with 3-Tesla MRI and Cushing's Disease

 

Louis J. Kim1, Gregory P. Lekovic1, William L. White1, John Karis2

1 Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona

2 Division of Neuroradiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona

ABSTRACT

 

Because radiographic visualization of a pituitary microadenoma is frequently difficult, we hypothesized that microadenomas associated with Cushing's disease may be better resolved and localized via acquisition with 3-Tesla (3T) compared with standard 1.5-Tesla (1.5T) magnetic resonance imaging (MRI). Five patients (four females, one male; age range, 14 to 50 years old) with endocrine and clinical confirmation of Cushing's disease underwent 1.5T and 3T MRI and corticotropin-releasing hormone stimulation/inferior petrosal sinus sampling (IPSS) as part of their preoperative evaluation. All patients underwent a transnasal trans-sphenoidal pituitary adenomectomy. In two cases, tumor could not be localized on either 1.5T or 3T MRI on the initial radiologist's review. In two other cases, the 1.5T images delineated the tumor location, but it was more clearly defined on 3T MRI. In a fifth case, the 1.5T MRI showed a probable right-sided adenoma. However, on both 3T MRI and at surgical exploration the tumor was localized on the left side. Therefore, in three of five cases, 3T MRI either more clearly defined tumors seen on 1.5T MRI or predicted the location of tumor contrary to the 1.5T images. IPSS identified the correct side of the tumor in two patients, an incorrect location in two patients, and was indeterminate in one patient. In certain cases 3T MRI is a new tool that may ameliorate imaging difficulties associated with adrenocorticotrophic hormone-secreting pituitary adenomas. Its role in the diagnostic evaluation of Cushing's disease will be better defined with further experience.

 

KEYWORDS

 

3-Tesla MRI - Cushing's disease - pituitary gland - imaging

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Interesting - my 1.5t image showed a right tumor, my 3t showed a left tumor, the surgeon found tumor on both sides.

Thanks Mary

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