Oeckler R, Fink U
Neurochirurgische Klinik der Ludwig-Maximilians-Universität München, Federal Republic of Germany.
Acta Neurochir (Wien). 1987;88(1-2):20-5. doi: 10.1007/BF01400510.
The search of reliable imaging methods to detect the substrate for persisting hypersecretion in patients operated on for hormonactive pituitary adenoma prompted us to study the possibilities of the newly available Magnetic Resonance Imaging (MRI) technique in this regard. Pre- and postoperative MRI-studies where performed in 5 patients with persisting GH excess following transsphenoidal surgery as well as in 3 patients with micro- and 2 patients with macroprolactinomas. The MRI-findings were correlated with the results of the endocrinological examinations. Two acromegalic patients and three cases with microprolactinomas, who were successfully operated upon as defined by the functional criteria were also included to obtain a baseline for normal postoperative findings. The MRI-study was positive in all of the five patients with persisting GH-overproduction. In prolactinomas, the substrate of hypersecretion could only be detected, when the PRL-value exceeded 2,000 microU/ml. MRI may present an important diagnostic method for evaluating further treatment options in patients with remaining hormonal hypersecretion following transsphenoidal adenomectomy, particularly with regard to a second surgical approach.
为了寻找可靠的成像方法来检测接受激素活性垂体腺瘤手术的患者持续分泌过多激素的底物，促使我们研究新出现的磁共振成像（MRI）技术在这方面的可能性。对5例经蝶窦手术后仍存在生长激素过量分泌的患者、3例微泌乳素瘤患者和2例大泌乳素瘤患者进行了术前和术后MRI研究。MRI检查结果与内分泌检查结果相关。还纳入了2例肢端肥大症患者和3例微泌乳素瘤患者，这些患者根据功能标准手术成功，以获得术后正常结果的基线。在所有5例持续生长激素分泌过多的患者中，MRI研究均呈阳性。在泌乳素瘤中，只有当泌乳素值超过2000微单位/毫升时，才能检测到分泌过多的底物。MRI可能是评估经蝶窦腺瘤切除术后仍存在激素分泌过多的患者进一步治疗方案的重要诊断方法，特别是在考虑二次手术入路方面。
