Silent, but not unseen: multimicrocystic aspect on T2‐weighted MRI in silent corticotroph adenomas. (5th May 2014)

• Record Type: Journal Article
• Authors: Cazabat, Laure; Dupuy, Martin; Boulin, Anne; Bernier, Michèle; Baussart, Bertrand; Foubert, Luc; Raffin‐Sanson, Marie‐Laure; Caron, Philippe; Bertherat, Jérôme; Gaillard, Stéphan
• Is Part Of: Clinical endocrinology. Volume 81:Number 4(2014:Oct.)
• Page Start: 566
• Page End: 572
• Publication Date: 2014-05-05
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12443
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12443-abs-0001"> <title>Summary</title> <sec id="cen12443-sec-0001" sec-type="section"> <title>Objective</title> <p>Silent corticotroph adenomas (SCAs) present as nonfunctional pituitary tumours in routine pre‐operative evaluation. The objective of this study was to evaluate the diagnostic accuracy of MRI T2‐weighted sequences for detecting the corticotroph subtype pre‐operatively.</p> </sec> <sec id="cen12443-sec-0002" sec-type="section"> <title>Design</title> <p>The pre‐operative T2‐weighted MRI sequences were retrospectively evaluated in patients with SCA and two control groups: clinically manifest corticotroph macroadenomas (CSMs) and nonfunctional gonadotroph macroadenomas (NFGMs). All were selected from a registry of 1096 patients in whom transsphenoidal surgery was performed in the same tertiary reference centre. T2‐weighted MRI sequences were independently classified by one senior endocrinologist and one senior radiologist who were blinded to the clinical and histological features.</p> </sec> <sec id="cen12443-sec-0003" sec-type="section"> <title>Patients</title> <p>Seventeen patients with SCA, 14 with CSM and 60 with NFGM were included in this study.</p> </sec> <sec id="cen12443-sec-0004" sec-type="section"> <title>Measurements</title> <p>Pituitary MRI with T2‐weighted sequences. Two aspects were retained: multiple microcysts (MMs) and the absence of microcysts. Hormonal data included plasma prolactin, IGF‐1, testosterone or oestradiol, LH, FT4, TSH, morning plasma cortisol and an ACTH‐stimulation test, when available.</p> </sec> <sec id="cen12443-sec-0005" sec-type="section"> <title>Results</title> <p>Multiple microcysts were present in 76% (13/17) of SCAs, 21% (3/14) of CSMs and 5% (3/60) of NFGMs. The presence of MMs in clinically nonfunctioning macroadenomas had a sensitivity of 76% and a specificity of 95% for predicting SCA.</p> </sec> <sec id="cen12443-sec-0006" sec-type="section"> <title>Conclusion</title> <p>The presence of MMs in T2‐weighted MRI is a good diagnostic tool to suggest the corticotroph subtype in an apparently nonfunctional pituitary tumour.</p> </sec> </abstract>