Three-dimensional reconstruction and morphological characterization of pituitary macroadenomas.
BACKGROUND
The aim was to investigate the relationship between the tumor (clinicopathologic and radiological) characteristics and the morphological parameters of pituitary macroadenoma or giant adenoma patients using a three-dimensional (3D) reconstructed model.


METHODS
Magnetic resoanance imaging (MRI) was performed preoperatively; tumor grade was determined by the Knosp-Steiner classification and tumor morphology by the SIPAP classification. Pituitary adenomas and adjacent structures were reconstructed three-dimensionally by volume rendering.


RESULTS
Fifty-two and 6 patients underwent surgery via the transnasal transsphenoidal or pterional approach, respectively. Knosp-Steiner grades I to IV adenomas were observed in 5.2%, 25.9%, 22.4% and 46.6% of the patients, respectively. The 3D model was reconstructed in all cases with superb delineation of tumor morphology and the spatial relationship between the tumor and adjacent tissues. Pituitary adenomas were categorized into intrasellar (13.8%), suprasellar (20.7%), infrasellar (17.2%), and lobulated adenomas (48.3%). Suprasellar adenomas had the smallest (2.27 ±3.22 cm(3)) and lobulated adenomas the largest volume (24.61 ±30.50 cm(3)). Intrasellar adenomas were all functioning, while 75%, 60% and 60.7%, respectively, of suprasellar, infrasellar and lobulated adenomas were nonfunctioning, with a significant association between tumor morphology and secretory function (p = 0.005).


CONCLUSIONS
Three-dimensional reconstruction of pituitary macroadenomas offers a simplified morphological classification of pituitary adenomas and may be helpful for neurosurgeons to categorize and characterize pituitary adenomas.
Department of Neurosurgery, Fuzhou General Hospital, Xiamen University Medical College, Fujian, China.
Shou-Sen
SS
Wang
Department of Neurosurgery, Fuzhou General Hospital, Xiamen University Medical College, Fujian, China.
Lin
L
Wei
Department of Neurosurgery, Fuzhou General Hospital, Xiamen University Medical College, Fujian, China.
Jun-Jie
JJ
Jing
Department of Neurosurgery, Fuzhou General Hospital, Xiamen University Medical College, Fujian, China.
Shang-Ming
SM
Zhang
3D reconstruction; SIPAP classification; morphology; pituitary macroadenomas; volume rendering