Clival Invasion on Multi-Detector CT in 390 Pituitary Macroadenomas: Correlation with Sex, Subtype and Rates of Operative Complication and Recurrence

Clival invasion, a rare but potentially significant complication of pituitary adenoma, is difficult to detect on MR imaging. Because CT is widely used in adjunct guidance of pituitary surgery and it has recently been suggested that preoperative CT may add useful diagnostic information in addition to...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2011-04, Vol.32 (4), p.785-789
Main Authors: CHEN, X, DAI, J, AI, L, RU, X, WANG, J, LI, S, YOUNG, G. S
Format: Article
Language:English
Subjects:
Adenoma - diagnostic imaging
Adenoma - epidemiology
Adenoma - surgery
Adult
Biological and medical sciences
Cranial Fossa, Posterior - diagnostic imaging
Female
Head and Neck
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local - diagnostic imaging
Neoplasm Recurrence, Local - epidemiology
Nervous system
Pituitary Neoplasms - diagnostic imaging
Pituitary Neoplasms - epidemiology
Pituitary Neoplasms - surgery
Postoperative Complications - diagnostic imaging
Postoperative Complications - epidemiology
Preoperative Care
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Retrospective Studies
Risk Factors
Sex Distribution
Tomography, X-Ray Computed - methods
Tomography, X-Ray Computed - statistics & numerical data
Treatment Outcome
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Summary:Clival invasion, a rare but potentially significant complication of pituitary adenoma, is difficult to detect on MR imaging. Because CT is widely used in adjunct guidance of pituitary surgery and it has recently been suggested that preoperative CT may add useful diagnostic information in addition to pituitary MR imaging, we performed the first large cross-sectional imaging study to define the image attributes, clinical correlates, and prognostic implications of clival invasion on CT for pituitary adenoma surgical guidance. Preoperative CT images from 390 patients with histopathologically diagnosed pituitary macroadenoma were reviewed retrospectively and classified by the presence and degree of clival invasion. Tumor volume, tumor subtype, patient sex, operative complication, and recurrence rates were compared between groups. After we corrected for multiple correlations, the most significant independent risk factor for clival invasion was female sex (OR=3.62, P=.014, multinomial logistic regression), followed by large tumor volume (OR=1.08, P
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A2364