metrizamide and Adenoma

Topics: Acromegaly; Adenoma; Adrenocorticotropic Hormone; Angiography; Brain Neoplasms; Diagnosis, Differential; Humans; Metrizamide; Myelography; Pituitary Diseases; Pituitary Gland; Pituitary Neoplasms; Prolactin; Tomography, X-Ray Computed

Topics: Adenoma; Diagnosis, Differential; Empty Sella Syndrome; Humans; Metrizamide; Pituitary Neoplasms; Pneumoencephalography; Tomography, X-Ray Computed

Topics: Adenoma; Adolescent; Adult; Cisterna Magna; Diagnosis, Differential; Female; Humans; Male; Metrizamide; Middle Aged; Pituitary Neoplasms; Tomography, X-Ray Computed

Sixty-four patients with intrasellar and suprasellar lesions on conventional computed tomography (CT) have been studied retrospectively to determine the indications for metrizamide CT cisternography (MCTC). Enhancing or calcified lesions, like a craniopharyngioma, pituitary adenoma, meningioma or aneurysm are adequately evaluated by conventional CT and MCTC is usually not needed. Determination of the exact suprasellar extent of an enhancing pituitary adenoma is best accomplished with coronal thin-section conventional CT alone. However, for isodense or hypodense suprasellar and intrasellar lesions, MCTC is indicated if conventional CT does not define their extent accurately. Differentiation of an empty sella from the occasional entirely lucent pituitary adenoma or other low density intrasellar lesions remains difficult by conventional CT at times, especially when the infundibulum is not identified. Then MCTC will also be indicated.

Topics: Adenoma; Adult; Aged; Cerebral Ventricle Neoplasms; Cerebral Ventriculography; Cranial Nerve Neoplasms; Craniopharyngioma; Diagnosis, Differential; Empty Sella Syndrome; Female; Glioma; Humans; Male; Metrizamide; Myelography; Optic Chiasm; Pituitary Diseases; Pituitary Neoplasms; Retrospective Studies; Tomography, X-Ray Computed

Topographic anatomy of the pituitary fossa was studied by 2 mm thin-section CT scan (Somatom II). Nineteen with normal pituitary (control group) and 20 with suspected pituitary abnormality were selected. Plain and contrast CT were performed in all cases. Contrast CT was carried out immediately after the rapid infusion of 220 ml of 30% iodinated contrast medium. In all of control group but two, pituitary gland was detected as homogenous density and its density was as same as density of normal brain tissues, and was enhanced in degree of about 25 CT number. In 2 cases, small low density was visualized in the pituitary gland. Pituitary gland was differentiated from cavernous sinus was usually higher than the pituitary gland. In abnormal group, the microadenoma of the pituitary gland was diagnosed in 5 cases and 3 out of 5 cases was proved by surgery. All 3 microadenomas proved slightly dense by plain CT and enhanced higher than normal pituitary gland by contrast CT. Polytomograms showed no abnormality of the sella turcica in one of these 3 cases. Although 3 microadenomas were detected by the abnormal enhancement, we are not sure whether all of microadenoma can be detected by CT alone. Arachnoid herniation into the pituitary fossa was diagnosed in 7 of control group and 2 of abnormal group. Four out of these 9 cases were verified by using Metrizamide CT. By plain thin-section CT, the diagnosis of arachnoid herniation seems to be possible without Metrizamide CT.

Topics: Adenoma; Encephalocele; Humans; Metrizamide; Pituitary Gland; Pituitary Neoplasms; Radiographic Image Enhancement; Tomography, X-Ray Computed

The time and place for the use of plain films of the skull, arteriography and venography, CT with and without contrast enhancement, and metrizamide cisternography as a replacement for air encephalography, for the diagnosis of the various kinds of pituitary adenomas is discussed in conjunction with a report of the experience with eight pituitary adenomas.

Topics: Adenoma; Adult; Aged; Cerebral Angiography; Cisterna Magna; Female; Humans; Male; Metrizamide; Middle Aged; Pituitary Neoplasms; Pneumoencephalography; Sella Turcica; Tomography, X-Ray Computed

The radiological manifestations of 16 pituitary adenomas, six meningiomas and 14 craniopharyngiomas were reviewed. The differential diagnosis of these tumors is possible with a few exceptions when skull radiography, CT, angiography and metrizamide cisternography are carefully evaluated. Prolonged injection angiography (PIA) is particularly important for demonstrating the contours of pituitary adenomas and meningiomas. Metrizamide cisternography is indicated when the tumor contours are obscure using PIA, or when the differential diagnosis is uncertain.

Topics: Adenoma; Cerebral Angiography; Cisterna Magna; Craniopharyngioma; Diagnosis, Differential; Humans; Meningeal Neoplasms; Meningioma; Metrizamide; Pituitary Neoplasms; Skull; Tomography, X-Ray Computed

In children, hypothalamic-hypophyseal syndromes such as diabetes insipidus, precocious puberty, growth retardation, and panhypopituitarism can be due either to structural lesions or to functional disorders of the cerebral endocrine complex. When clinical and endocrinological parameters fail to distinguish between these etiologies, neuroradiographical diagnosis becomes extremely important. Although conventional intravenously enhanced computed tomography (IVCT) is satisfactory for the diagnosis of lesions larger than 1 cm, metrizamide CT cisternography (MCTC) greatly improves the diagnostic yield for smaller juxtapituitary masses in the suprasellar cistern, clearly defines their sizes and relationships with contiguous structures, and definitively confirms the diagnosis of empty sella syndrome. Six patients with endocrinopathies and normal or ambiguous IVCT findings are presented to illustrate how MCTC can influence their management and outcome without the patient discomfort and technical complexity associated with pneumoencephalography.

Topics: Adenoma; Adolescent; Astrocytoma; Brain Diseases; Brain Neoplasms; Child; Dysgerminoma; Empty Sella Syndrome; Female; Hamartoma; Humans; Hypothalamo-Hypophyseal System; Infant; Male; Metrizamide; Pituitary Neoplasms; Tomography, X-Ray Computed; Tuber Cinereum

Metrizamide computerized tomographic cisternography was performed with a small dose and low concentration of intrathecal metrizamide using a newer generation of computerized tomography scanner for the evaluation of sellar and suprasellar abnormalities. The examination was performed with thin sections in axial, direct coronal, and (when feasible) direct sagittal projections in a high-resolution technique. The relationship of the lesions with carotid arteries, optic chiasms, and hypothalamic structures was accurately defined.

Topics: Adenoma; Adenoma, Chromophobe; Adolescent; Adult; Cranial Nerve Neoplasms; Empty Sella Syndrome; Female; Humans; Male; Meningioma; Metrizamide; Middle Aged; Myelography; Optic Chiasm; Pituitary Diseases; Pituitary Neoplasms; Sella Turcica; Tomography, X-Ray Computed

A total of 30 patients with pituitary adenoma was studied by sagittal polytomography en route to coronal and axial computed tomography (CT) cisternography after a low FDA-approved dose of 6 ml of 170 mg I/ml metrizamide via lumbar injection. The requirement for defining the relation of the optic nerves and chiasm to the intrasellar contents or suprasellar mass before proton beam irradiation or certain surgical approaches was satisfied. Pneumoencephalography as a supplemental procedure to CT and CT cisternography was replaced. The concomitant elimination of conventional sellar polytomography and pneumoencephalography results in decreased total radiation exposure and a more comfortable, expeditious workup.

Topics: Adenoma; Evaluation Studies as Topic; Humans; Injections, Spinal; Metrizamide; Pituitary Neoplasms; Pneumoencephalography; Posture; Sella Turcica; Spinal Puncture; Tomography, X-Ray Computed

Seventy-five suprasellar metrizamide cisternograms were obtained, 25 in normal individuals who had had cervical myelography and 50 in patients with pituitary or juxtapituitary lesions. The technique accurately delineates a suprasellar extension of a small or moderate-sized pituitary lesion and usually shows its relationship to the optic chiasm. Large suprasellar masses, however, are not well visualized. 'Empty sellae' are readily demonstrated and have a high incidence in both normal individuals and those with pituitary tumors. This procedure can be supplemented by metrizamide CT cisternography and is simpler to perform and often better tolerated by patients than is pneumoencephalography.

Topics: Acromegaly; Adenoma; Adenoma, Chromophobe; Contrast Media; Craniopharyngioma; Empty Sella Syndrome; Female; Humans; Male; Metrizamide; Myelography; Nelson Syndrome; Pituitary Neoplasms

Preliminary results indicate that simultaneous cerebral angiography with computed tomography may be a decisive investigation in the diagnosis of small intrasellar neoplasms.

Topics: Adenoma; Angiography; Cerebral Angiography; Female; Humans; Metrizamide; Middle Aged; Pituitary Neoplasms; Tomography, X-Ray Computed

The use of stereotactic necrotizing proton beam irradiation for treatment of pituitary adenoma has prompted the use of computed tomographic cisternography (CTC) as an adjunct to intravenous enhanced computed tomographic (CT) scanning. A technique for obtaining sagittal pluridirectional tomographic sections prior to coronal and axial CTC is outlined. Experience with 19 cases is described.

Topics: Adenoma; Adult; Aged; Empty Sella Syndrome; Female; Humans; Male; Metrizamide; Middle Aged; Myelography; Sella Turcica; Skull Neoplasms; Tomography, X-Ray Computed

Topics: Adenoma; Adolescent; Adult; Aged; Cerebral Ventriculography; Cisterna Magna; Female; Humans; Infant; Male; Metrizamide; Middle Aged; Myelography; Pituitary Neoplasms; Solubility

The utility of diagnostic tests for pituitary adenoma was compared in 12 patients. Endocrine and radiologic studies were always abnormal, even when neuro-ophthalmologic tests were normal. In most cases, both tomography of the sella turcica and CT scan revealed a mass in the region of the sella turcica. For more precise definition of suprasellar extension of the mass, metrizamide CT cisternography or tomographic pneumoencephalography with metrizamide provided similar details, although CT cisternography was much more easily done. Angiography provides a means to exclude an aneurysm or vascular malformation, a vascular tumor, or an aberrant course of the internal carotid artery.

Topics: Adenoma; Adolescent; Adult; Aged; Female; Humans; Male; Metrizamide; Middle Aged; Pituitary Neoplasms; Sella Turcica; Tomography, X-Ray; Tomography, X-Ray Computed; Vision Disorders; Visual Fields

Topics: Adenoma; Brain Neoplasms; Computers; Contrast Media; Evaluation Studies as Topic; Humans; Iodobenzoates; Metrizamide; Sella Turcica; Tomography, X-Ray