Evaluation of the Sellar and Parasellar Regions

Chin, Brian M.; Orlandi, Richard R.; Wiggins, Richard H.

doi:10.1016/j.mric.2012.05.007

Cited by 36 publications

(44 citation statements)

References 104 publications

(134 reference statements)

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“…The initial radiological criteria of CS invasion, which underlined the importance of cavernous sinus ICA (Figure 3) [71,93,94], have been further refined and include analysis of the pituitary gland (its interposition between the tumor and CS is a sign of no invasion), of the CS venous compartments, CS size, ICA, and CS lateral wall (CSLW) displacement [68,71,[95][96][97][98][99][100][101]. All these criteria underline the difficulty of radiological diagnosis of CS invasion, which is considered certain only when total encasement of the ICA is present [11,67,71,87,94,95,97,[101][102][103][104][105].…”

Section: Radiological Criteria and Classificationsmentioning

confidence: 99%

Pituitary Adenomas and Invasiveness from Anatomo-Surgical, Radiological, and Histological Perspectives: A Systematic Literature Review

Serioli

Doglietto

Fiorindi

et al. 2019

Cancers

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Invasiveness in pituitary adenomas has been defined and investigated from multiple perspectives, with varying results when its predictive value is considered. A systematic literature review, following PRISMA guidelines, was performed, searching PubMed and Scopus databases with terms that included molecular markers, histological, radiological, anatomical and surgical data on invasiveness of pituitary adenomas. The results showed that differing views are still present for anatomical aspects of the sellar region that are relevant to the concept of invasiveness; radiological and histological diagnoses are still limited, but might improve in the future, especially if they are related to surgical findings, which have become more accurate thanks to the introduction of the endoscope. The aim is to achieve a correct distinction between truly invasive pituitary adenomas from those that, in contrast, present with extension in the parasellar area through natural pathways. At present, diagnosis of invasiveness should be based on a comprehensive analysis of radiological, intra-operative and histological findings.

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Section: Radiological Criteria and Classificationsmentioning

confidence: 99%

Pituitary Adenomas and Invasiveness from Anatomo-Surgical, Radiological, and Histological Perspectives: A Systematic Literature Review

Serioli

Doglietto

Fiorindi

et al. 2019

Cancers

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“…Traumatic etiologies, such as stalk transection or postoperative sella, can be characterized using thin-section T2-weighted images. MRI with and without IV contrast is especially useful for the detection and characterization of inflammatory lesions of the stalk and neoplastic invasion [23,82]. MRI with IV contrast may only be performed for use in operative guidance and should not be considered a first-line imaging test.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria® Neuroendocrine Imaging

Burns

Policeni

Bykowski

et al. 2019

Journal of the American College of Radiology

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Neuroendocrine dysfunction includes suspected hyper-and hypofunction of the pituitary gland. Causative lesions may include primary masses of the pituitary such as pituitary microadenomas and macroadenomas, as well as extrinsic masses, typically centered in the suprasellar cistern. Clinical syndromes related to hormonal dysfunction can be caused by excessive hormonal secretion or by inhibited secretion due to mass effect upon elements of the hypothalamic-pituitary axis. Additionally, complications such as hemorrhage may be seen in the setting of an underlying mass and can result in hormonal dysfunction. MRI with high-resolution protocols is the best firstline test to evaluate the sella turcica and parasellar region. CT provides complementary information regarding bony anatomy, and may be appropriate as a first-line test in certain instances, but it provides less detail and lesion characterization when compared to MRI.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.Disclaimer: The ACR Committee on Appropriateness Criteria and its expert panels have developed criteria for determining appropriate imaging examinations for diagnosis and treatment of specified medical condition(s). These criteria are intended to guide radiologists, radiation oncologists, and referring physicians in making decisions regarding radiologic imaging and treatment. Generally, the complexity and severity of a patient's clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient's condition are ranked. Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document. The availability of equipment or personnel may influence the selection of appropriate imaging procedures or treatments. Imaging techniques classified as investigational by the FDA have not been considered in developing these criteria; however, study of new equipment and applications should be encouraged. The ultimate decision regarding the appropriateness of any specific radiologic examination or treatment must be made by the referring physician and radiologist in light of all the circumstances presented in an individual examination.

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“…79 A meta-analysis of 9 studies investigating reproductive outcomes in women with congenital uterine anomalies grouped women into 3 different categories: arcuate uteri, canalization defections, and unification defects. 98 Hyperprolactinemia caused by these masses can cause infertility. Those with canalization defects such as septate and subseptate uteri were found to have difficulty conceiving, first-trimester pregnancy loss, preterm birth, and fetal malpresentation.…”

Section: Discussion Of Imaging Modalities By Variantmentioning

confidence: 99%

“…Those with canalization defects such as septate and subseptate uteri were found to have difficulty conceiving, first-trimester pregnancy loss, preterm birth, and fetal malpresentation. 39,98,100 No Other Signs or Symptoms Following appropriate clinical workup, a suspected cause of infertility will not be identified in some women. 80 In 24 cases of surgically proven MDA, MRI was 100% accurate, 2-D TVS was 92% accurate, and hysterosalpingogram was only 16.7% accurate.…”

Section: Discussion Of Imaging Modalities By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria® Infertility

Wall¹,

Javitt²,

Glanc³

et al. 2015

Ultrasound Quarterly

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Appropriate imaging for women undergoing infertility workup depends upon the clinician's suspicion for potential causes of infertility. Transvaginal US is the preferred modality to assess the ovaries for features of polycystic ovary syndrome (PCOS), the leading cause of anovulatory infertility. For women who have a history or clinical suspicion of endometriosis, which affects at least one third of women with infertility, both MRI and pelvic US can provide valuable information. If tubal occlusion is suspected, whether due to endometriosis, previous pelvic inflammatory disease, or other cause, hysterosalpingogram (HSG) is the preferred method of evaluation. To assess for anatomic causes of recurrent pregnancy loss (RPL) such as Müllerian anomalies, synechiae, and leiomyomas, saline infusion sonohysterography, MRI and 3-D US are most appropriate. Up to 10% of women suffering recurrent pregnancy loss have a congenital Müllerian anomaly. When assessment of the pituitary gland is indicated, MRI is the imaging exam of choice.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

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Evaluation of the Sellar and Parasellar Regions

Cited by 36 publications

References 104 publications

Pituitary Adenomas and Invasiveness from Anatomo-Surgical, Radiological, and Histological Perspectives: A Systematic Literature Review

Pituitary Adenomas and Invasiveness from Anatomo-Surgical, Radiological, and Histological Perspectives: A Systematic Literature Review

ACR Appropriateness Criteria® Neuroendocrine Imaging

ACR Appropriateness Criteria® Infertility

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