title: Intraoperative Magnetic Resonance Imaging During Endoscopic Transsphenoidal Surgery of Growth Hormone-Secreting Pituitary Adenomas.
abstract: BACKGROUND
  The effect of intraoperative magnetic resonance imaging (iMRI) on the extent of sellar region tumors treated endonasally has been described in previous research. However, the effects of iMRI on endocrinologic outcome of growth hormone-secreting adenomas have been studied in only a few small cohort studies.
  
  
  METHODS
  Inclusion criteria were primary transsphenoidal surgery for growth hormone-secreting adenoma from January 2009 to December 2014, a minimum follow-up of 1 year, complete endocrinologic data, at least 1 iMRI, and at least 2 postoperative magnetic resonance images. The cohort consisted of 105 patients (54 females, 51 males) with a mean age of 48.3 years (range, 7-77 years). There were 16 microadenomas and 89 macroadenomas.
  
  
  RESULTS
  Endocrinologic remission in the whole cohort was achieved in 64 of the patients (60.9%). Resection after iMRI was attempted in 22 of the cases (20.9%). Resection after iMRI led to hormonal remission in 9 cases (8.6%). Endocrinologic postoperative deficit was observed in 10 cases (12.5%). Postoperative cerebrospinal fluid leakage indicated the necessity to reoperate in 3 cases (3.8%). No neurologic deterioration was observed.
  
  
  CONCLUSIONS
  iMRI influences not only the morphologic extent of pituitary adenomas resection but also the endocrinologic results. We encourage the routine application of iMRI in pituitary adenoma surgery, including hormone-secreting pituitary tumors.
authors.affiliation: Department of Neurosurgery, 1st Faculty of Medicine, Charles University, Central Military Hospital, Prague, Czech Republic. Electronic address: netuka.david@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Netuka
authors.affiliation: Department of Neurosurgery, 1st Faculty of Medicine, Charles University, Central Military Hospital, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Májovský
authors.affiliation: Department of Neurosurgery, 1st Faculty of Medicine, Charles University, Central Military Hospital, Prague, Czech Republic.
authors.forename: Václav
authors.initials: V
authors.lastname: Masopust
authors.affiliation: Radiodiagnostic Unit, Central Military Hospital, Prague, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Belšán
authors.affiliation: 3rd Department of Internal Medicine, 1st Medical Faculty, Charles University, Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Marek
authors.affiliation: 3rd Department of Internal Medicine, 1st Medical Faculty, Charles University, Prague, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Kršek
authors.affiliation: 3rd Department of Internal Medicine, 1st Medical Faculty, Charles University, Prague, Czech Republic.
authors.forename: Václav
authors.initials: V
authors.lastname: Hána
authors.affiliation: 3rd Department of Internal Medicine, 1st Medical Faculty, Charles University, Prague, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Ježková
authors.affiliation: 3rd Department of Internal Medicine, 1st Medical Faculty, Charles University, Prague, Czech Republic.
authors.forename: Václav
authors.initials: V
authors.lastname: Hána
authors.affiliation: Department of Neurosurgery, 1st Faculty of Medicine, Charles University, Central Military Hospital, Prague, Czech Republic.
authors.forename: Vladimír
authors.initials: V
authors.lastname: Beneš
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D012074:Remission Induction / Q000379:methods; D055815:Young Adult
keywords: Acromegaly; Growth hormone; Intraoperative MRI; Pituitary adenoma; Transsphenoidal surgery