Cavernous sinus invasion by pituitary adenoma: MR imaging.
OBJECTIVE
To define magnetic resonance (MR) imaging criteria for the diagnosis of cavernous sinus invasion by pituitary adenoma.


METHODS
The MR images obtained in 106 patients (86 female, 20 male; age range, 16-71 years) were reviewed retrospectively by two physicians. The standard-of-reference criteria for invasion were the surgical findings. A chi(2) analysis was performed, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for nine groups of MR imaging signs were computed.


RESULTS
Invasion of the cavernous sinus was certain (PPV, 100%) if the percentage of encasement of the internal carotid artery (ICA) by tumor was 67% or greater. It was highly probable if the carotid sulcus venous compartment was not depicted (PPV, 95%) or the line joining the lateral wall of the intracavernous and supracavernous ICAs was passed by the tumor (PPV, 85%). It was definitely not invaded (NPV, 100%) if the percentage of encasement of the intracavernous ICA was lower than 25% or the line joining the medial wall of the intracavernous and supracavernous ICAs was not passed by the tumor.


CONCLUSIONS
The radiologic diagnosis of cavernous sinus invasion by pituitary adenoma remains difficult, but the above-mentioned criteria may be of assistance.
Cottier
J P
JP
Department of Neuroradiology, CHRU Bretonneau, 2 bis, Bd Tonnellé, 37044 Tours cedex, France. cottier@med.univ-tours.fr
Destrieux
C
C
Brunereau
L
L
Bertrand
P
P
Moreau
L
L
Jan
M
M
Herbreteau
D
D
D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D011336:Probability; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019043:Vascular Neoplasms / Q000473:pathology* / Q000601:surgery