Errors in radiation diagnosis of pituitary adenomas

I. Dedov, A. I. Bukhman, V. G. Shlykova
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Abstract

Craniography, computer-aided tomography (CAT), and magnetic imaging (MI) are carried out in 236 patients with suspected pituitary adenoma. Causes of hypo- and hyperdiagnosis are analyzed. Algorithm of using radiodiagnostic methods is developed. Pituitary adenomas are recognized by assessing the size of the pituitary and sella turcica, detailed study of pituitary structure and status of the sella turcica walls and the adjacent tissues. Radiodiagnosis in combination with clinical laboratory findings permit the differentiation of pituitary adenomas from other pathological processes in this gland (hyperplasia, atrophy, inflammation, and dystrophy) and from changes in the neighboring tissues (calcification of different origin, increase of intracranial pressure, etc.). For minimizing the diagnostic errors, craniography is to precede CAT or MI. CAT or MI should be carried out in the “amplification ” mode, and in difficult diagnostic cases should be repeated over time. For an experienced specialist, MI by its informative value is the method of choice for the diagnosis of pituitary diseases (adenomas, cysts, etc.).
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垂体腺瘤放射诊断的错误
本文对236例疑似垂体腺瘤的患者进行了颅脑造影、计算机辅助断层扫描(CAT)和磁共振成像(MI)检查。分析了低诊断和高诊断的原因。提出了使用放射诊断方法的算法。垂体腺瘤是通过评估垂体和蝶鞍的大小,详细研究垂体结构和蝶鞍壁及邻近组织的状态来识别的。放射诊断结合临床实验室结果可以将垂体腺瘤与该腺体的其他病理过程(增生、萎缩、炎症和营养不良)以及邻近组织的变化(不同来源的钙化、颅内压升高等)区分开来。为减少诊断错误,应在CAT或MI之前进行颅脑造影。CAT或MI应在“放大”模式下进行,在诊断困难的病例中应随时间重复进行。对于经验丰富的专家来说,心肌梗死的信息价值是诊断垂体疾病(腺瘤、囊肿等)的首选方法。
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