{"title":"垂体瘤放射学特征的形态计量分析以及与星状上扩展垂体大腺瘤视力障碍相关的视路变形","authors":"Chia-Yu Chen, Jin-Shuen Chen, Yao-Shen Chen, Chun-Hao Yin, Po-Chin Wang, Shuo-Hsiu Hsu, Yao-Chung Yang, Wei-Chuan Liao","doi":"10.1016/j.wneu.2024.11.019","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To validate the correlation between visual impairment (VI) and suprasellar extension (SSE) in pituitary macroadenomas and to identify patients at heightened risk of preoperative visual deficits by analyzing anatomical distortion of optic nerve and optic chiasm (OC) using preoperative magnetic resonance imaging.</p><p><strong>Methods: </strong>Ninety-seven patients with pituitary macroadenomas and SSE, treated between January 2015 and April 2022, were analyzed. Associations between VI, demographic data, SSE, and optic pathway deformation were assessed. SSE cutoff points for predicting VI were determined using receiver operating characteristic curves, with univariate and multivariate logistic regression identifying potential risk factors.</p><p><strong>Results: </strong>Of the 97 patients, 47 had confirmed VI. Independent predictors of VI included visual symptoms lasting >1 month, sagittal SSE >10.35 mm, and vertical OC width >5.6 mm. Additional risk factors were older age, nonfunctioning pituitary adenoma, coronal SSE, dumbbell-shaped tumors, large and giant adenomas, reduced optic nerve diameter, increased horizontal OC width, and thinned OC thickness.</p><p><strong>Conclusions: </strong>Tumor morphology and optic pathway distortion predict preoperative VI in patients with pituitary macroadenomas. These findings support the development of a viable approach for assessing VI risk in clinical practice, aiding in decisions regarding optimal surgical timing.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123436"},"PeriodicalIF":1.9000,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Morphometric Analysis of Radiological Features of Pituitary Tumors and Optic Pathway Distortion Associated with Visual Impairment in Pituitary Macroadenomas with Suprasellar Extension.\",\"authors\":\"Chia-Yu Chen, Jin-Shuen Chen, Yao-Shen Chen, Chun-Hao Yin, Po-Chin Wang, Shuo-Hsiu Hsu, Yao-Chung Yang, Wei-Chuan Liao\",\"doi\":\"10.1016/j.wneu.2024.11.019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To validate the correlation between visual impairment (VI) and suprasellar extension (SSE) in pituitary macroadenomas and to identify patients at heightened risk of preoperative visual deficits by analyzing anatomical distortion of optic nerve and optic chiasm (OC) using preoperative magnetic resonance imaging.</p><p><strong>Methods: </strong>Ninety-seven patients with pituitary macroadenomas and SSE, treated between January 2015 and April 2022, were analyzed. Associations between VI, demographic data, SSE, and optic pathway deformation were assessed. SSE cutoff points for predicting VI were determined using receiver operating characteristic curves, with univariate and multivariate logistic regression identifying potential risk factors.</p><p><strong>Results: </strong>Of the 97 patients, 47 had confirmed VI. Independent predictors of VI included visual symptoms lasting >1 month, sagittal SSE >10.35 mm, and vertical OC width >5.6 mm. Additional risk factors were older age, nonfunctioning pituitary adenoma, coronal SSE, dumbbell-shaped tumors, large and giant adenomas, reduced optic nerve diameter, increased horizontal OC width, and thinned OC thickness.</p><p><strong>Conclusions: </strong>Tumor morphology and optic pathway distortion predict preoperative VI in patients with pituitary macroadenomas. These findings support the development of a viable approach for assessing VI risk in clinical practice, aiding in decisions regarding optimal surgical timing.</p>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":\" \",\"pages\":\"123436\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-12-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.11.019\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.11.019","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Morphometric Analysis of Radiological Features of Pituitary Tumors and Optic Pathway Distortion Associated with Visual Impairment in Pituitary Macroadenomas with Suprasellar Extension.
Objective: To validate the correlation between visual impairment (VI) and suprasellar extension (SSE) in pituitary macroadenomas and to identify patients at heightened risk of preoperative visual deficits by analyzing anatomical distortion of optic nerve and optic chiasm (OC) using preoperative magnetic resonance imaging.
Methods: Ninety-seven patients with pituitary macroadenomas and SSE, treated between January 2015 and April 2022, were analyzed. Associations between VI, demographic data, SSE, and optic pathway deformation were assessed. SSE cutoff points for predicting VI were determined using receiver operating characteristic curves, with univariate and multivariate logistic regression identifying potential risk factors.
Results: Of the 97 patients, 47 had confirmed VI. Independent predictors of VI included visual symptoms lasting >1 month, sagittal SSE >10.35 mm, and vertical OC width >5.6 mm. Additional risk factors were older age, nonfunctioning pituitary adenoma, coronal SSE, dumbbell-shaped tumors, large and giant adenomas, reduced optic nerve diameter, increased horizontal OC width, and thinned OC thickness.
Conclusions: Tumor morphology and optic pathway distortion predict preoperative VI in patients with pituitary macroadenomas. These findings support the development of a viable approach for assessing VI risk in clinical practice, aiding in decisions regarding optimal surgical timing.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS