Hordejuk Dawid, Cheung Yee-Ming M, Wang Wei, Smith Timothy, Laws Edward, Kaiser Ursula B, Min Le
Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (D.H., Y.M.C., U.B.K., L.M.).
Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, and Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts (W.W.).
Ann Intern Med. 2023 Mar;176(3):298-302. doi: 10.7326/M22-1728. Epub 2023 Feb 28.
The estimated prevalence of pituitary lesions is 10% to 38.5% in radiologic studies. However, how frequently these incidental lesions should be monitored by serial pituitary magnetic resonance imaging (MRI) remains unclear.
To evaluate changes in pituitary microadenomas over time.
Retrospective, longitudinal cohort study.
Mass General Brigham, Boston, Massachusetts.
Evidence of pituitary microadenoma from MRI.
Dimensions of pituitary microadenomas.
During the study period (from 2003 to 2021), 414 patients with pituitary microadenomas were identified. Of the 177 patients who had more than 1 MRI, 78 had no change in the size of the microadenoma over time, 49 had an increase in size, 34 had a decrease in size, and 16 had both an increase and decrease in size. By linear mixed model analysis, the estimated slope was 0.016 mm/y (95% CI, -0.037 to 0.069). In the subgroup analysis, pituitary adenomas with a baseline size of 4 mm or less tended to increase in size. The estimated slope was 0.09 mm/y (CI, 0.020 to 0.161). In contrast, in the subgroup with baseline tumor size greater than 4 mm, the size tended to decrease. The estimated slope was -0.063 mm/y (CI, -0.141 to 0.015).
Retrospective cohort, some patients were lost to follow-up for unknown reasons, and data were limited to local large institutions.
During the study period, approximately two thirds of the microadenomas remained unchanged or decreased in size. The growth, if any, was slow. These findings suggest that less frequent pituitary MRI surveillance for patients with incidental pituitary microadenomas may be safe.
None.
在放射学研究中，垂体病变的估计患病率为10%至38.5%。然而，这些偶然发现的病变通过垂体磁共振成像（MRI）序列监测的频率仍不清楚。
评估垂体微腺瘤随时间的变化。
回顾性纵向队列研究。
马萨诸塞州波士顿的布莱根妇女医院。
MRI显示垂体微腺瘤的证据。
垂体微腺瘤的大小。
在研究期间（2003年至2021年），共识别出414例垂体微腺瘤患者。在177例接受了不止一次MRI检查的患者中，78例微腺瘤大小随时间无变化，49例增大，34例缩小，16例大小既有增大又有缩小。通过线性混合模型分析，估计斜率为0.016 mm/年（95%CI，-0.037至0.069）。在亚组分析中，基线大小为4mm或更小的垂体腺瘤倾向于增大。估计斜率为0.09 mm/年（CI，0.020至0.161）。相反，在基线肿瘤大小大于4mm的亚组中，大小倾向于缩小。估计斜率为-0.063 mm/年（CI，-0.141至0.015）。
回顾性队列研究，部分患者因不明原因失访，数据仅限于当地大型机构。
在研究期间，约三分之二的微腺瘤大小保持不变或缩小。即使有增长，速度也很慢。这些发现表明，对于偶然发现垂体微腺瘤的患者，减少垂体MRI监测频率可能是安全的。
无。
