Comparison between computed tomography and magnetic resonance imaging in the postoperative evaluation of acromegalic patients.

ABSTRACT

Twelve acromegalic patients who underwent transphenoidal resection of a GH-secreting pituitary adenoma were evaluated postoperatively by Computed Tomography (CT) and Magnetic Resonance (MR). CT and MR findings were compared with surgical and clinical results. MR was more accurate than CT in delineating postoperative abnormalities of the infundibulum, diaphragma sellae and optic chiasm. In three cases MR differentiated packing materials from adenomatous tissue. In cases with biochemical evidence of residual or recurrent tumor, MR clearly demonstrated intra- or extrasellar adenomatous tissue and the spatial relationship between the soft tissue mass and the cavernous sinuses. CT was superior to MR only in demonstrating sellar floor disruption. MR imaging detected the anatomical causes of clinical abnormalities in almost all acromegalic patients with incomplete recovery after surgery. On the basis of MR results it is possible to plan additional surgery, radiation therapy or medical treatment. MR may be the radiological procedure of choice for both surgical treatment planning and postoperative follow-up.