Vézina J L, Hardy J, Yamashita M
Arq Neuropsiquiatr. 1975 Jun;33(2):119-27. doi: 10.1590/s0004-282x1975000200002.
The early radiographic changes of the sella turcica in the cases of hypersecreting pituitary adenomas (Cushing disease, acromegaly, amenorrhea-galactorrhea) are reported and discussed. The finding of the double contour of the sellar floor and the small crescentic bulging of its antero-inferior wall, with the aid of the tomographic cuts of the sella, has permited the diagnosis of the microadenoma'a localization. With this it si possible the achievement of a selective excision of the lesion in the initial stage, when the tumor has not caused yet irreversible damage to the inside normal pituitary tissue. This surgery is performed in the precocious stage with the primary goal to preserve the normal gland, without hurt it to avoid postoperative hipopituitarism. A anatomo-radiologic classification of the alterations sella turcica in 4 grades is made, which is of great utility for the surgical prognostic, since we have observed clinical and biological cure over 90% in the grade 1, 75% in the grade 2, 50% in the grade 3 and up to 10% in the grade 4 in the first surgery.
报告并讨论了分泌过多型垂体腺瘤(库欣病、肢端肥大症、闭经-溢乳症)患者蝶鞍的早期影像学变化。借助蝶鞍的体层摄影切片,发现蝶鞍底部的双重轮廓及其前下壁的小新月形隆起,有助于诊断微腺瘤的定位。由此,在肿瘤尚未对垂体内部正常组织造成不可逆转损害的初始阶段,就有可能实现对病变的选择性切除。这种手术在早期进行,主要目的是保留正常腺体,避免损伤它以防止术后垂体功能减退。对蝶鞍改变进行了四级解剖学-放射学分类,这对手术预后非常有用,因为我们观察到在首次手术中,1级的临床和生物学治愈率超过90%,2级为75%,3级为50%,4级高达10%。