Magnetic resonance imaging appearance of the medial wall of the cavernous sinus for the assessment of cavernous sinus invasion by pituitary adenomas

Cao, Lei; Chen, Hongjie; Jiang, Hong; Ma, M.; Zhong, Qun; Wang, Shousen

doi:10.1016/j.neurad.2013.06.003

Cited by 27 publications

(14 citation statements)

References 25 publications

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“…6,22,31 In pituitary adenomas, in particular, MRI allows for both prediction of extent of invasion as well as delineation of tumor from healthy gland. 8,24 The increased spatial and contrast resolution afforded by 7T imaging may allow for more accurate prediction of cavernous sinus invasion, as seen in Figure 6A.…”

Section: Discussionmentioning

confidence: 99%

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

et al. 2017

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Background Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of skull base. In this study, we apply a 7T imaging protocol to patients with skull base tumors and compare the images to clinical standard of care. Methods Images were acquired at 7T on 11 patients with skull base lesions. Two neuroradiologists evaluated clinical 1.5T, 3T, and 7T scans for detection of intracavernous cranial nerves and ICA branches. Detection rates were compared. Images were utilized for surgical planning and uploaded to a neuronavigation platform and used to guide surgery. Results Image analysis yielded improved detection rates of cranial nerves and ICA branches at 7T. 7T images were successfully incorporated into preoperative planning and intraoperative neuronavigation. Conclusion Our study represents the first application of 7T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7T MRI compared to 3T and 1.5 T, and found that integration of 7T into surgical planning and guidance was feasible. These results suggest a potential for 7T MRI to reduce surgical complications. Future studies comparing standardized 7T, 3T, and 1.5 T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7T MRI for endonasal endoscopic surgical efficacy.

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Section: Discussionmentioning

confidence: 99%

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

et al. 2017

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“…36 Modest improvements in SNR (approximately 2-fold) with 3.0-T MR imaging has been shown to improve the detection of cavernous sinus invasion. 6 We have found that ESC resulted in an approximately 10-fold improvement in SNR in the sella/pituitary gland.…”

Section: Discussionmentioning

confidence: 70%

Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery

Chittiboina

Talagala²,

Merkle

et al. 2016

JNS

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OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing’s disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. METHODS Five cadaver heads were used for preclinical testing of the ESC. The ESC (a double-turn, 12-mm-diameter surface coil made from 1-mm-diameter copper wire) was developed to obtain images in a 1.5-T MR scanner. The ESC was placed (via a standard sublabial TSS approach) on the anterior sella face. Clinical MR scans were obtained using the 8-channel head coil and ESC as the receiver coils. Using the ESC, ultra–high-resolution, 3D, balanced fast field echo (BFFE) and T1-weighted imaging were performed at resolutions of 0.25 × 0.25 × 0.50 mm3 and 0.15 × 0.15 × 0.30 mm3, respectively. RESULTS Region-of-interest analysis indicated a 10-fold increase in the signal-to-noise ratio (SNR) of the pituitary when using the ESC compared with the 8-channel head coil. ESC-related improvements (p < 0.01) in the SNR were inversely proportional to the distance from the ESC tip to the anterior pituitary gland surface. High-resolution BFFE MR imaging obtained using ESC revealed a number of anatomical features critical to pituitary surgery that were not visible on 8-channel MR imaging, including the pituitary capsule, the intercavernous sinus, and microcalcifications in the pars intermedia. These ESC imaging findings were confirmed by the pathological correlation with whole-mount pituitary sections. CONCLUSIONS ESC can significantly improve SNR in the sellar region intraoperatively using current 1.5-T MR imaging platforms. Improvement in SNR can provide images of the sella and surrounding structures with unprecedented resolution. Clinical use of this ESC may allow for MR imaging detection of previously occult pituitary adenomas and identify microscopic invasion of the dura or cavernous sinus.

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“…Therefore, better contrast between adenoma, CS and internal carotid artery is necessary on MR images for CS invasion evaluation of pituitary adenoma. Most of the previous studies analyzed the radiological anatomic parameters based on conventional T1-weighted images [9,14,15], which sometimes could not clearly depict morphological details in sella region. It was reported that SPACE could increase the SI of CS, which contains the venous plexus, relatively slow-flowing blood [7] and provide excellent flow void of the internal carotid artery [8].…”

Section: Discussionmentioning

confidence: 99%

Effective performance of contrast enhanced SPACE imaging in clearly depicting the margin of pituitary adenoma

Wang

Yao

et al. 2014

Pituitary

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Magnetic resonance imaging appearance of the medial wall of the cavernous sinus for the assessment of cavernous sinus invasion by pituitary adenomas

Cited by 27 publications

References 25 publications

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery

Effective performance of contrast enhanced SPACE imaging in clearly depicting the margin of pituitary adenoma

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