Intraoperative US of the pituitary gland. Work in progress.
OBJECTIVE
To evaluate the use of ultrasound (US) of the pituitary gland during transsphenoidal surgery as a means of detecting microadenomas in patients with Cushing disease.


METHODS
Thirteen patients with Cushing disease and one with acromegaly underwent US during transsphenoidal surgery. Mechanically oscillating transducers (10 MHz [n = 8] or 15 MHz [n = 6]) mounted on a 15-cm-long probe were used.


RESULTS
Seven adenomas were definitely visualized, two were poorly seen, and four were overlooked. Small tumors (< 5 mm in diameter) tended to be hypoechoic; larger ones, hyperechoic. All four overlooked adenomas were imaged with the 15-MHz transducer. The cavernous sinuses and internal carotid arteries could be seen, but minimal invasion of the medial wall of the cavernous sinus could not.


CONCLUSIONS
Pituitary microadenomas can be detected with transsphenoidal US; however, evaluation of larger series with instrumentation developed specifically for transsphenoidal application will be necessary to determine the ultimate value of this technique.
Doppman
J L
JL
Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892.
Ram
Z
Z
Shawker
T H
TH
Oldfield
E H
EH
D000172:Acromegaly / Q000000981:diagnostic imaging / Q000601:surgery; D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000328:Adult; D003480:Cushing Syndrome / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000000981:diagnostic imaging* / Q000601:surgery; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography