Zhang Huijian, Zhang Shuai, Shang Mingchao, Wang Jiaxing, Wei Liangfeng, Wang Shousen
Department of Neurosurgery, 900th Hospital of Joint Logistic Support Force, Fuzhou, Fujian, China.
Department of Neurosurgery, Huanggang Central Hospital, Huanggang, Hubei, China.
Front Neurol. 2023 Jan 27;14:1049577. doi: 10.3389/fneur.2023.1049577. eCollection 2023.
We aimed to investigate the magnetic resonance imaging (MRI) findings and clinical significance of position and changes in morphology of the pituitary stalk following pituitary adenoma (PA) resection using a transsphenoidal approach.
We collected clinical and MRI data of 108 patients with PA after transsphenoidal surgery. Diameter, length, and coronal deviation of the pituitary stalk were measured pre-, post-, and mid-term post-operatively, to observe pituitary stalk morphology.
Of 108 patients, 53 pituitary stalks were recognisable pre-operatively. The angle between the pituitary stalk and the median line was 7.22°-50.20° (average, 25.85°) in 22 patients with left-sided pituitary stalks and 5.32°-64.05° (average, 21.63°) in 20 patients with right-sided pituitary stalks. Of 42 patients with preoperative pituitary stalk deviation, 41 had an early postoperative recovery and 1 had increased deviation. In the mid-term postoperative period, 21 of 42 patients had pituitary stalks located centrally. In 53 patients, the pituitary stalk length was 1.41-11.74 mm (mean, 6.12 mm) pre-operatively, 3.61-11.63 mm (mean, 6.93 mm) in the early postoperative period, and 5.37-17.57 mm (mean, 8.83 mm) in the mid-term postoperative period. In the early postoperative period, 58 (53.70%) patients had posterior pituitary bright spots (PPBS) and 28 (25.92%) had diabetes insipidus (DI).
Pre-operatively, the pituitary stalk was compressed and thinned. Post-operatively, it could be stretched to a "normal state", and its position showed a gradual centring trend. Post-operatively, the length of the pituitary stalk gradually increased. The PPBS in the early postoperative period negatively correlated with postoperative DI.
我们旨在研究经蝶窦入路垂体腺瘤（PA）切除术后垂体柄位置及形态变化的磁共振成像（MRI）表现及其临床意义。
我们收集了108例经蝶窦手术后PA患者的临床和MRI数据。术前、术后及术后中期测量垂体柄的直径、长度和冠状位偏移，以观察垂体柄形态。
108例患者中，53例术前可识别垂体柄。左侧垂体柄的22例患者中，垂体柄与中线的夹角为7.22°-50.20°（平均25.85°），右侧垂体柄的20例患者中，该夹角为5.32°-64.05°（平均21.63°）。42例术前垂体柄偏移的患者中，41例术后早期恢复，1例偏移增加。术后中期，42例患者中有21例垂体柄位于中央。53例患者中，术前垂体柄长度为1.41-11.74mm（平均6.12mm），术后早期为3.61-11.63mm（平均6.93mm），术后中期为5.37-17.57mm（平均8.83mm）。术后早期，58例（53.70%）患者有垂体后叶亮点（PPBS），28例（25.92%）有尿崩症（DI）。
术前垂体柄受压变细。术后，它可伸展至“正常状态”，其位置呈逐渐居中趋势。术后，垂体柄长度逐渐增加。术后早期的PPBS与术后DI呈负相关。
