Marcovitz S, Wee R, Chan J, Hardy J
Division of Endocrinology, Montreal General Hospital, McGill University, Quebec, Canada.
AJNR Am J Neuroradiol. 1988 Jan-Feb;9(1):19-22.
Between 1980 and 1986, 58 patients (23 women and 35 men) had coronal CT scans of the sella turcica for suspected growth hormone-secreting adenoma and underwent transsphenoidal exploration. The CT examinations were performed with a fourth-generation EMI scanner (CT 7070), and reports of the preoperative CT were compared with the findings at transsphenoidal exploration. The same neurosurgeon performed all the operations. In three patients arthritic changes in the neck caused difficulties in positioning, which made it impossible to obtain adequate coronal CT scans. These nondiagnostic examinations are excluded from the statistical calculations. In all 55 patients with scans that were able to be evaluated, distinct adenomas were found at surgery. Among these were 39 macroadenomas (diameter larger than 10 mm) and 16 microadenomas. Three macroadenomas and two microadenomas caused combined hypersecretion of growth hormone and prolactin. All macroadenomas were localized correctly on the preoperative CT scans (sensitivity 100%), but in two cases there was a discrepancy in size of more than 5 mm compared with the operative findings. Preoperative CT scans correctly localized 13 of 16 microadenomas, for a sensitivity rate of 81.2%. Two patients with negative scans and one patient in whom the adenoma was found in a location other than that reported on the preoperative CT scan were considered to have negative scans for the purpose of statistical calculations. If both correct localization and size estimation within 2 mm of that found at surgery are considered, the accuracy rate was 90.9% for the entire group of patients, 94.9% for those with macroadenomas, and 81.2% for microadenomas.
1980年至1986年间，58例患者（23名女性和35名男性）因疑似生长激素分泌腺瘤接受了蝶鞍区冠状位CT扫描，并接受了经蝶窦探查术。CT检查使用的是第四代EMI扫描仪（CT 7070），术前CT报告与经蝶窦探查结果进行了比较。所有手术均由同一位神经外科医生进行。3例患者因颈部关节炎改变导致定位困难，无法获得足够的冠状位CT扫描。这些无法诊断的检查被排除在统计计算之外。在所有55例能够进行评估的扫描患者中，手术时发现了明显的腺瘤。其中有39例大腺瘤（直径大于10mm）和16例微腺瘤。3例大腺瘤和2例微腺瘤导致生长激素和催乳素联合分泌过多。所有大腺瘤在术前CT扫描上均定位正确（敏感性100%），但有2例与手术结果相比大小差异超过5mm。术前CT扫描正确定位了16例微腺瘤中的13例，敏感性为81.2%。为了统计计算，2例扫描结果为阴性的患者和1例腺瘤位于术前CT扫描报告位置以外的患者被视为扫描结果为阴性。如果将正确定位和手术时发现的大小估计在2mm以内都考虑在内，整个患者组的准确率为90.9%，大腺瘤患者为94.9%，微腺瘤患者为81.2%。
