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57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Application of MRI criteria for cavernous sinus (CS) invasion of pituitary adenomas on normal parasellar anatomy

Anwendung von MRT-Kriterien für die Invasivität humaner Hypophysenadenome in den Sinus cavernosus auf die normale periselläre Anatomie

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  • corresponding author U.J. Knappe - Klinik für Neurochirurgie, Dr. Horst Schmidt Klinik, Wiesbaden
  • C. Jaursch-Hancke - Fachbereich Endokrinologie, Deutsche Klinik für Diagnostik, Wiesbaden
  • U. Lörcher - Fachbereich Radiologie, Deutsche Klinik für Diagnostik, Wiesbaden

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 04.51

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc268.shtml

Published: May 8, 2006

© 2006 Knappe et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: To evaluate the anatomical relations of parasellar structures and to apply different MRI criteria of cavernous sinus invasion by pituitary adenomas to normal sellar anatomy.

Methods: 3 mm coronal T2 - weighted MRI - images (1.5 T) obtained from 119 individuals with no known pituitary disorder (59 f, 60m, mean age 48 years, 17 mo - 87 years) were analyzed using different techniques assessing the relation of the pituitary and the ICA.

Results: The medial wall of the CS was visible in 34%. The mean distance between the ICA and the pituitary was 2.8 mm (range 1 to 7 mm). In 42% the gland seemed to have contact to the ICA. Of these, the area of contact was the medial surface of the ICA in 67%, in 32% additionally in the upper aspect of the vessel. The line drawn between the medial rim of the intra- and supracavernous ICA was crossed by the pituitary in 9% of all cases, the intercarotid line in 5%. This was related to age (Chi-square p=0.03). In 41% of all individuals there was marked difference of the anatomical findings between both sides.

Conclusions: Our results indicate inter- and intraindividual variations of the parasellar compartment. These have to be taken into account using established MRI criteria for cavernous sinus invasion. The impact of arterial hypertension on the anatomy of the ICA has to be elucidated.