title: Magnetic resonance imaging validation of pituitary gland compression and distortion by typical sellar pathology.
abstract: OBJECTIVE
  Identification of the normal pituitary gland is an important component of presurgical planning, defining many aspects of the surgical approach and facilitating normal gland preservation. Magnetic resonance imaging is a proven imaging modality for optimal soft-tissue contrast discrimination in the brain. This study is designed to validate the accuracy of localization of the normal pituitary gland with MRI in a cohort of surgical patients with pituitary mass lesions, and to evaluate for correlation between presurgical pituitary hormone values and pituitary gland characteristics on neuroimaging.
  
  
  METHODS
  Fifty-eight consecutive patients with pituitary mass lesions were included in the study. Anterior pituitary hormone levels were measured preoperatively in all patients. Video recordings from the endoscopic or microscopic surgical procedures were available for evaluation in 47 cases. Intraoperative identification of the normal gland was possible in 43 of 58 cases. Retrospective MR images were reviewed in a blinded fashion for the 43 cases, emphasizing the position of the normal gland and the extent of compression and displacement by the lesion.
  
  
  RESULTS
  There was excellent agreement between imaging and surgery in 84% of the cases for normal gland localization, and in 70% for compression or noncompression of the normal gland. There was no consistent correlation between preoperative pituitary dysfunction and pituitary gland localization on imaging, gland identification during surgery, or pituitary gland compression.
  
  
  CONCLUSIONS
  Magnetic resonance imaging proved to be accurate in identifying the normal gland in patients with pituitary mass lesions, and was useful for preoperative surgical planning.
authors.affiliation: Departments of Radiology and.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Cho
authors.forename: Garni
authors.initials: G
authors.lastname: Barkhoudarian
authors.forename: Liangge
authors.initials: L
authors.lastname: Hsu
authors.forename: Wenya Linda
authors.initials: WL
authors.lastname: Bi
authors.forename: Amir A
authors.initials: AA
authors.lastname: Zamani
authors.forename: Edward R
authors.initials: ER
authors.lastname: Laws
mesh_terms: D015331:Cohort Studies; D004724:Endoscopy / Q000592:standards; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008866:Microsurgery / Q000592:standards; D019635:Neurosurgical Procedures / Q000592:standards; D010902:Pituitary Gland / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care / Q000592:standards*; D012189:Retrospective Studies; D012658:Sella Turcica / Q000473:pathology* / Q000601:surgery; D016037:Single-Blind Method; D025321:Surgery, Computer-Assisted / Q000592:standards*