الفهرس | Only 14 pages are availabe for public view |
Abstract The integrity of hypophyseal macroadenoma is important data for neurosurgeons because it helps them decide whether to use an endoscopic trans-nasal or transcranial method to remove the tumor. The objective of our assessment was to establish the preview value of DW-MRIs as a non-invasive screening approach for predicting the uniformity of tumor in the pituitary macroadenoma. This is a prospective research study conducted on 40 patients hospitalized in the Neurosurgery department at Cairo University Hospitals with pituitary macroadenoma from march 2017 to june 2021. We classified the tumor as a soft type that was easily succable without the need for dissecting, a solid type that was not succable at all and was excised by the peace meal technique with the pituitary forceps, and an intermediate type that was removed with dissection and ring curette. Intraoperative documentation of the tumor consistency is done by the surgeon to be correlated with the diffusion-weighted image and ADC (Aquired Diffusion Coefficient) value of the tumor. Our study found correlation between ADC values and DW Images and tumor consistencies and so; we recommend inclusion of DWI and ADC maps in routine pre-operative imaging of pituitary macroadenomas which is valuable in preoperative assessment of the tumor consistency and very important in planning of the appropriate surgical approach. The cut off value of ADC of 0.6 × 10−3 mm2/s can be used to differentiate between pituitary macroadenomas easily excised by curettage and suction, (soft and intermediate consistency) against those not easily removed by curettage and suction (hard consistency). |