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Radiology, Vol 192, 111-115, Copyright © 1994 by Radiological Society of North America

ARTICLES

Intraoperative US of the pituitary gland. Work in progress

JL Doppman, Z Ram, TH Shawker and EH Oldfield
Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892.

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.


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R. Fahlbusch, B. v Keller, O. Ganslandt, J. Kreutzer, and C. Nimsky
Transsphenoidal surgery in acromegaly investigated by intraoperative high-field magnetic resonance imaging
Eur. J. Endocrinol., August 1, 2005; 153(2): 239 - 248.
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J. Newell-Price, P. Trainer, M. Besser, and A. Grossman
The Diagnosis and Differential Diagnosis of Cushing's Syndrome and Pseudo-Cushing's States
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