1
|
Vivancos Sánchez C, Navia Álvarez P, Alfonso Carrillo C, Parra Ramírez P, Pérez López C. Carotid pseudoaneurysms after endoscopic transsphenoidal surgery for acromegaly. ENDOCRINOL DIAB NUTR 2024; 71:35-37. [PMID: 38326177 DOI: 10.1016/j.endien.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 02/09/2024]
Affiliation(s)
| | - Pedro Navia Álvarez
- Departamento de Neuroradiología Intervencionista, Servicio de Radiología, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | |
Collapse
|
2
|
Dannhoff G, Bozzi MT, Scibilia A, Severac F, Ollivier I, Mallereau CH, Todeschi J, Chibbaro S, Proust F, Gaillard S, Cebula H. Anatomical variations of the cavernous Internal Carotid Artery: Validation of an MRI-based classification. Clin Neurol Neurosurg 2023; 227:107647. [PMID: 36889239 DOI: 10.1016/j.clineuro.2023.107647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Variations of the cavernous Internal Carotid Artery (ICA) angulation (C4-bend) have been classified into 4 anatomical subtypes with particular surgical relevance, as a very angulated ICA comes in closest contact with the pituitary gland leading to higher risk of iatrogenic vascular injury. This study aimed to validate this classification using current routine imaging techniques. METHODS The different cavernous ICA bending angles were measured on 109 MRI TOF sequences, within a retrospective database of patients with no sellar lesions. Each ICA was classified into one of 4 anatomical subtypes as already defined in a previous study [1]. Interrater agreement was assessed by a Kappa Correlation Coefficient. RESULTS Kappa Correlation Coefficient was of 0.90 [0.82-0.95], validating the strong level of agreement between all observers when using the present classification. CONCLUSION Classification of the cavernous ICA in 4 subtypes appears statistically valid on routinely used pre-operative MRI, providing an efficient tool to estimate the vascular iatrogenic risk prior to endoscopic endonasal transsphenoidal surgery.
Collapse
Affiliation(s)
- Guillaume Dannhoff
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France.
| | - Maria Teresa Bozzi
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Antonino Scibilia
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - François Severac
- Department of Public Health, Hautepierre University Hospital, Strasbourg, France
| | - Irène Ollivier
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | | | - Julien Todeschi
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Salvatore Chibbaro
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - François Proust
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| | - Stephan Gaillard
- Department of Neurosurgery, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Hélène Cebula
- Department of Neurosurgery, Hautepierre University Hospital, Strasbourg, France
| |
Collapse
|
3
|
Raghu ALB, Flower HD, Statham PFX, Brennan PM, Hughes MA. Sellar Remodeling after Surgery for Nonfunctioning Pituitary Adenoma: Intercarotid Distance as a Predictor of Recurrence. J Neurol Surg B Skull Base 2020; 81:579-584. [PMID: 33134026 DOI: 10.1055/s-0039-1693700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022] Open
Abstract
Introduction As they grow, pituitary adenoma can remodel the sella turcica and alter anatomical relationships with adjacent structures. The intercarotid distance (ICD) at the level of the sella is a measure of sella width. The purpose of this study was to (1) assess how ICD changes after transsphenoidal surgery and (2) explore whether the extent of ICD change is associated with tumor recurrence. Methods A retrospective analysis of preoperative and postoperative coronal magnetic resonance imaging (MRI) scans was carried out by two independent assessors on patients who underwent transsphenoidal surgery for nonfunctioning pituitary macroadenomas. Preoperative tumor volume and any change in ICD following surgery were recorded and compared between groups. Logistic regression models of recurrence were generated. Results In 36 of 42 patients, ICD fell after surgery (mean = 1.8 mm) and six cases were static. At time of follow-up (mean = 77 months), 25 had not required further intervention and 17 had undergone second surgery or radiosurgery. In patients in whom no further intervention has yet been necessary, the postoperative reduction in ICD was significantly smaller than in those who required repeat intervention (1.1 vs. 2.7 mm respectively, p < 0.01). ICD decrease was weakly correlated with tumor volume ( r = 0.35). ICD decrease was a significant predictor of recurrence (odds ratio [OR] = 3.15; 95% confidence interval [CI]: 1.44-6.87), largely independent of tumor volume. Conclusion For most patients, ICD falls following surgical excision of a nonfunctioning pituitary macroadenoma. A greater reduction in ICD postsurgery appears to predict recurrence. Change in ICD shows promise as a radiographic tool for prognosticating clinical course after surgery.
Collapse
Affiliation(s)
- Ashley L B Raghu
- Edinburgh Medical School, University of Edinburgh, Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Hannah D Flower
- Edinburgh Medical School, University of Edinburgh, Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Patrick F X Statham
- Department of Clinical Neurosciences, NHS Lothian, Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Paul M Brennan
- Edinburgh Medical School, University of Edinburgh, Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland.,Department of Clinical Neurosciences, NHS Lothian, Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Mark A Hughes
- Edinburgh Medical School, University of Edinburgh, Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland.,Department of Clinical Neurosciences, NHS Lothian, Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
4
|
Jayashankar N. Endoscopic Transnasal Transsphenoidal Pituitary Surgery in Acromegaly: Anatomical Variations and Surgical Considerations. Neurol India 2020; 68:579-580. [PMID: 32643666 DOI: 10.4103/0028-3886.289017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- N Jayashankar
- Department of Otorhinolaryngology and Skull Base Surgery, Nanavati Superspeciality Hospital, Mumbai, Maharashtra, India
| |
Collapse
|
5
|
Rajagopal N, Thakar S, Hegde V, Aryan S, Hegde AS. Morphometric Alterations of the Sphenoid Ostium and other Landmarks in Acromegaly: Anatomical Considerations and Implications in Endoscopic Pituitary Surgery. Neurol India 2020; 68:573-578. [PMID: 32643665 DOI: 10.4103/0028-3886.288996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The sphenoid ostium (SO) is an important landmark for the endoscopic surgeon. Changes in size and position of the SO and variations in other skull base landmarks in acromegalics have not been adequately evaluated. Aims The authors evaluated the morphometry and location of the SO and other landmarks in acromegaly and compared these findings with those in nonfunctioning pituitary adenomas (NFPAs). Methods In this retrospective case-control study, the dimensions and location of the SO and other skull base landmarks were radiologically evaluated in 18 patients with growth hormone (GH)-secreting adenomas. These findings were analyzed in relation to preoperative GH levels and compared with 18 age- and sex-matched controls with NFPAs. Results The dimensions of the SO were significantly larger in the GH-adenoma group (P < 0.05). The SO was further from the midline (P = 0.04) and closer to the sphenopalatine foramen (SPF) (P = 0.02) in the GH-adenoma group, and this finding correlated with increasing preoperative GH levels. Acromegalics demonstrated larger intracavernous carotid diameters (P = 0.05) and smaller intercarotid distances than the patients with NFPAs (P = 0.02). Conclusion The SO is larger and located higher up in the sphenoid face and closer to the SPF in patients with GH adenomas. Increasing GH levels in these patients correlate with the upward and lateral displacement of the SO. These patients demonstrate larger intracavernous carotid diameters and smaller intercarotid distances than patients with NFPAs. These morphological alterations are of particular relevance to the pituitary surgeon.
Collapse
Affiliation(s)
- Niranjana Rajagopal
- Department of Neurological Sciences, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| | - Sumit Thakar
- Department of Neurological Sciences, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| | - Vinay Hegde
- Department of Radiodiagnosis, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| | - Saritha Aryan
- Department of Neurological Sciences, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| | - Alangar S Hegde
- Department of Neurological Sciences, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India
| |
Collapse
|
6
|
Cozzi R, Ambrosio MR, Attanasio R, Bozzao A, De Marinis L, De Menis E, Guastamacchia E, Lania A, Lasio G, Logoluso F, Maffei P, Poggi M, Toscano V, Zini M, Chanson P, Katznelson L. Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues. Endocr Metab Immune Disord Drug Targets 2020; 20:1133-1143. [PMID: 31985386 PMCID: PMC7579251 DOI: 10.2174/1871530320666200127103320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/05/2019] [Accepted: 12/05/2019] [Indexed: 12/21/2022]
Abstract
Acromegaly is a rare disease. Improvements in lifespan in these patients have recently been reported due to transsphenoidal surgery (TSS), advances in medical therapy, and strict criteria for defining disease remission. This document reports the opinions of a group of Italian experts who have gathered together their prolonged clinical experience in the diagnostic and therapeutic challenges of acromegaly patients. Both GH and IGF-I (only IGF-I in those treated with Pegvisomant) are needed in the diagnosis and follow-up. Comorbidities (cardio-cerebrovascular disease, sleep apnea, metabolic derangement, neoplasms, and bone/joint disease) should be specifically addressed. Any newly diagnosed patient should be referred to a multidisciplinary team experienced in the treatment of pituitary adenomas.
Collapse
Affiliation(s)
- Renato Cozzi
- Address correspondence to this author at the Endocrinologia, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy; Tel: +39.347.5225490; E-mail:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Yan X, Chen X, Ge H, Zhu S, Lin Y, Kang D, Lin Z, Jiang C, Ding C. The Change in Distance Between Bilateral Internal Carotid Arteries in Acromegaly and Its Risk Factors. Front Endocrinol (Lausanne) 2020; 11:429. [PMID: 32733381 PMCID: PMC7358354 DOI: 10.3389/fendo.2020.00429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/01/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Studies investigating the change in distance between the bilateral internal carotid arteries (ICAs) in acromegalic patients have provided ambiguous results. The influencing factors of these changes have not been well-identified. Objective: To further investigate the change in distance between bilateral ICAs in acromegaly patients and identify the influencing factors of the change. Method: Patients diagnosed as acromegaly from Jan 2016 to Sep 2019 in the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University, were included in this study. Computed tomography angiography (CTA) or magnetic resonance angiography (MRA) data were obtained for all patients for three-dimensional reconstruction of the ICAs. Distance between bilateral ICAs was measured and recorded for assessment. Result: 172 patients including 86 cases with acromegaly in the study group and 86 cases with non-functional pituitary adenoma in the control group were enrolled in this study. The difference of adenoma sizes between two groups was not statistically significant. Patients in acromegaly group had significantly larger maximum distances between bilateral siphon carotid ectasias (25.5 ± 4.1 vs. 23.4 ± 3.5 mm, P = 0.001) and between bilateral lacerum segments (26.2 ± 3.2 vs. 24.1 ± 4.3 mm, P < 0.001) compared with those of patients with non-functional pituitary adenomas. Multivariate analysis showed that the increased bilateral ICAs distance was associated with disease duration (odds ratio = 1.01, 95% confidence interval = 1.01-1.02, P = 0.005) and refractory pituitary adenoma (odds ratio = 9.8, 95% confidence interval = 1.1-88.7, P = 0.043) but not with level of growth hormone (GH), insulin-like growth factor-1 (IGF-1) and adenoma size in acromegaly. Conclusion: Our study showed significant change in distance between the bilateral ICAs in acromegalic patients, comparing to patients with non-functional pituitary adenomas. The increased intercarotid artery distance is associated with disease duration but not with preoperative level of GH and IGF-1. Refractory pituitary adenoma and longer disease duration are the both risk factors of the increased ICAs distance in patient with acromegly.
Collapse
Affiliation(s)
- Xiaorong Yan
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiaoyong Chen
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Hongliang Ge
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Shinong Zhu
- Department of Neurosurgery, Jinjiang Hospital Jinnan Branch Courts, Jinjiang, China
| | - Yuanxiang Lin
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dezhi Kang
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhangya Lin
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- *Correspondence: Zhangya Lin
| | - Changzhen Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Changzhen Jiang
| | - Chenyu Ding
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Chenyu Ding
| |
Collapse
|
8
|
Radiotherapy in acromegaly: Long-term brain parenchymal and vascular magnetic resonance changes. J Neuroradiol 2018; 45:323-328. [PMID: 29505842 DOI: 10.1016/j.neurad.2018.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 01/21/2018] [Accepted: 02/07/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Radiation therapy (RT) effectiveness on hormonal reduction is proven in acromegaly; however, collateral long-term effects are still undetermined. This transversal neuroimaging study on a large cohort of acromegalic patients aimed to investigate the rate of parenchymal and vascular changes after RT. MATERIALS AND METHODS Thirty-six acromegalic patients underwent RT (RT+) after unsuccessful surgery and were compared to RT- acromegalic patients matched for age, gender, adenoma features, clinical and surgical history. All patients underwent magnetic resonance angiography (MRA) to investigate intracranial artery abnormalities and FLAIR sequence to assess white matter changes according to the Wahlund scale. RESULTS RT+ acromegalic patients had a higher rate of controlled disease (29/36 vs. 12/36, P<0.001). RT+ acromegalic patients had MRI/MRA evaluation 15.3±9.6 years after RT. RT+ acromegalic patients had a significantly higher Wahlund score than RT- acromegalic patients (6.03±6.41 vs. 2.53±3.66, P=0.006) due to increased white matter signal abnormalities at the level of the temporal lobes, the basal ganglia (insula) and the infratentorial regions, bilaterally. Among RT+ patients one died because of temporo-polar anaplastic astrocytoma, one suffered from a stroke due to right internal carotid artery occlusion, one presented with cystic degeneration of the temporal poles. Long-dated RT (>10 years before MR evaluation) was associated with a higher rate of RT-related white matter changes (P=0.0004). CONCLUSIONS RT seems to have created a cohort of patients with brain parenchymal changes whose clinical and cognitive impact is still unknown. These patients might require a prolonged MRI and MRA follow-up to promptly detect delayed RT-related complications and minimize their clinical consequences.
Collapse
|
9
|
Serra C, Maldaner N, Muscas G, Staartjes V, Pangalu A, Holzmann D, Soyka M, Schmid C, Regli L. The changing sella: internal carotid artery shift during transsphenoidal pituitary surgery. Pituitary 2017; 20:654-660. [PMID: 28828722 DOI: 10.1007/s11102-017-0830-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE Injuries to the internal carotid artery (ICA) are potentially lethal complications in transsphenoidal surgery (TSS) for pituitary lesions. The intercarotid distance (ICD) is thus a major parameter, determining the width of the surgical corridor in TSS. The purpose of the study is to investigate changes in ICD at different levels of the ICA during and after TSS using high definition intraoperative MRI (3T-iMRI). METHODS Pre-, intra- and 3 months postoperative MRI images of 85 TSS patients were reviewed. ICD was measured at the horizontal (ICDC4h) and vertical (ICDC4v) intracavernous C4 segment as well as at the C6 segment (ICDC6). Association between ICD change at different levels and time points were compared and potential factors predicting ICD reduction were analyzed. RESULTS ICD decreased intraoperatively at all three segments of ICA by -3% (median decreases: ICDC4h: -0.5 mm, ICDC4v: -0.7 mm ICDC6: -0.4 mm). At 3 months postoperative MRI, ICD reduced by a further -4%, -2% and -4% respectively (median decreases ICDC4h: -0.7, ICDC4v: -0.4 mm, ICDC6: -0.5 mm). Postoperative narrowing in ICD occurred independent of further resection after 3T-iMRI. ICD change correlated between different levels of the ICA indicating a uniform shift perioperatively. Preoperative ICD was significantly associated with the intraoperative reduction in ICDC4v and ICDC6. CONCLUSIONS We have demonstrated a uniform narrowing in ICD at different levels of the ICA during and after TSS adenoma resection. Surgeons should be aware of this change since it determines the width of the surgical corridor and can thus influence the ease of surgery.
Collapse
Affiliation(s)
- Carlo Serra
- Department of Neurosurgery, University Hospital of Zürich, University of Zürich, Zurich, Switzerland.
| | - Nicolai Maldaner
- Department of Neurosurgery, University Hospital of Zürich, University of Zürich, Zurich, Switzerland
| | - Giovanni Muscas
- Department of Neurosurgery, Tuscany School of Neurosurgery, University of Firenze, Florence, Italy
| | - Victor Staartjes
- Department of Neurosurgery, University Hospital of Zürich, University of Zürich, Zurich, Switzerland
| | - Athina Pangalu
- Department of Neuroradiology, University Hospital of Zürich, University of Zürich, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zürich, University of Zürich, Zurich, Switzerland
| | - Michael Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zürich, University of Zürich, Zurich, Switzerland
| | - Christoph Schmid
- Department of Endocrinology and Diabetes, University Hospital of Zürich, University of Zürich, Zurich, Switzerland
| | - Luca Regli
- Department of Neurosurgery, University Hospital of Zürich, University of Zürich, Zurich, Switzerland
| |
Collapse
|
10
|
Tabur S, Korkmaz H, Baysal E, Hatipoglu E, Aytac I, Akarsu E. Auditory changes in acromegaly. J Endocrinol Invest 2017; 40:621-626. [PMID: 28035526 DOI: 10.1007/s40618-016-0602-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/12/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study is to determine the changes involving auditory system in cases with acromegaly. MATERIALS AND METHODS Otological examinations of 41 cases with acromegaly (uncontrolled n = 22, controlled n = 19) were compared with those of age and gender-matched 24 healthy subjects. Whereas the cases with acromegaly underwent examination with pure tone audiometry (PTA), speech audiometry for speech discrimination (SD), tympanometry, stapedius reflex evaluation and otoacoustic emission tests, the control group did only have otological examination and PTA. Additionally, previously performed paranasal sinus-computed tomography of all cases with acromegaly and control subjects were obtained to measure the length of internal acoustic canal (IAC). RESULTS PTA values were higher (p < 0.001 for right ears and p = 0.001 for left ears), and SD scores were (p = 0.002 for right ears and p = 0.002 for left ears) lower in acromegalic patients. IAC width in acromegaly group was narrower compared to that in control group (p = 0.03 for right ears and p = 0.02 for left ears). When only cases with acromegaly were taken into consideration, PTA values in left ears had positive correlation with growth hormone and insulin-like growth factor-1 levels (r = 0.4, p = 0.02 and r = 0.3, p = 0.03). Of all cases with acromegaly 13 (32%) had hearing loss in at least one ear, 7 (54%) had sensorineural type and 6 (46%) had conductive type hearing loss. CONCLUSION Acromegaly may cause certain changes in the auditory system in cases with acromegaly. The changes in the auditory system may be multifactorial causing both conductive and sensorioneural defects.
Collapse
Affiliation(s)
- S Tabur
- Division of Endocrinology and Diabetes, Department of Internal Medicine, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - H Korkmaz
- Division of Endocrinology and Diabetes, Department of Internal Medicine, Endocrinology and Metabolic Disease, Edirne State Hospital, 22030, Edirne, Turkey.
| | - E Baysal
- Department of Otorhinolaryngology, Inonu University Medical Faculty, Malatya, Turkey
| | - E Hatipoglu
- Division of Endocrinology and Diabetes, Department of Internal Medicine, Biruni University, Istanbul, Turkey
| | - I Aytac
- Department of Otorhinolaryngology, Mardin Midyat State Hospital, Mardin, Turkey
| | - E Akarsu
- Division of Endocrinology and Diabetes, Department of Internal Medicine, Gaziantep University Medical Faculty, Gaziantep, Turkey
| |
Collapse
|
11
|
Manara R, Carlier RY, Righetto S, Citton V, Locatelli G, Colas F, Ermani M, Germain DP, Burlina A. Basilar Artery Changes in Fabry Disease. AJNR Am J Neuroradiol 2017; 38:531-536. [PMID: 28126747 DOI: 10.3174/ajnr.a5069] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 10/06/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Dolichoectasia of the basilar artery is a characteristic finding of Fabry disease. However, its prevalence, severity, and course have been poorly studied. This study quantitatively evaluated, by MRA, a panel of basilar artery parameters in a large cohort of patients with Fabry disease. MATERIALS AND METHODS Basilar artery mean diameter, curved length, "origin-to-end" linear distance (linear length), and tortuosity index ([curved length ÷ linear length] - 1) were retrospectively measured on 1.5T MRA studies of 110 patients with Fabry disease (mean age, 39.4 ± 18.6 years; 40 males) and 108 control patients (mean age, 42.0 ± 18.2 years; 40 males). RESULTS Patients with Fabry disease had increased basilar artery mean diameter (P < .001) and basilar artery linear length (P = .02) compared with control patients. Basilar artery curved length and tortuosity index correlated with age in both groups (P < .001), whereas basilar artery linear length correlated with age only in patients with Fabry disease (P = .002). Patients with Fabry disease showed a basilar artery curved length mean increase of 4.2% (9.7% in male patients with Fabry disease versus male control patients), whereas the basilar artery mean diameter had a mean increase of 12.4% (14.3% in male patients with Fabry disease versus male control patients). Male patients with Fabry disease had increased basilar artery mean diameter, curved length, and tortuosity index compared with female patients with Fabry disease (P = .04, P = .02, and P < .001, respectively) and male control patients (P < .001, P = .01, and P = .006, respectively). Female patients with Fabry disease demonstrated an age-dependent increase of basilar artery mean diameter that became significant (P < .001) compared with female control patients above the age of 45 years. CONCLUSIONS The basilar artery of patients with FD is subjected to major remodeling that differs according to age and sex, thus providing interesting clues about the pathophysiology of cerebral vessels in Fabry disease.
Collapse
Affiliation(s)
- R Manara
- From the Sezione di Neuroscienze (R.M.), University of Salerno, Salerno, Italy
| | | | - S Righetto
- Department of Neurosciences (S.R., V.C., M.E.), University of Padova, Padova, Italy
| | - V Citton
- Department of Neurosciences (S.R., V.C., M.E.), University of Padova, Padova, Italy
| | - G Locatelli
- S. Giovanni e Ruggi d'Aragona Hospital (G.L.), Salerno, Italy
| | - F Colas
- Radiology Division (R.Y.C., F.C.).,Division of Medical Genetics (F.C., D.P.G.), University of Versailles, Versailles, France
| | - M Ermani
- Department of Neurosciences (S.R., V.C., M.E.), University of Padova, Padova, Italy
| | - D P Germain
- Division of Medical Genetics (F.C., D.P.G.), University of Versailles, Versailles, France
| | - A Burlina
- Neurological Unit (A.B.), St. Bassiano Hospital, Bassano del Grappa, Italy.
| |
Collapse
|
12
|
Does MMP-9 Gene Polymorphism Play a Role in Pituitary Adenoma Development? DISEASE MARKERS 2017; 2017:5839528. [PMID: 28194042 PMCID: PMC5282418 DOI: 10.1155/2017/5839528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/23/2016] [Indexed: 12/19/2022]
Abstract
Purpose. To determine if the MMP-9 genotype has an influence on development of pituitary adenoma (PA). Methodology. The study enrolled n = 86 patients with PA and n = 526 healthy controls (reference group). The genotyping of MMP-9 was carried out using the real-time polymerase chain reaction method. Results. Our data demonstrated that the MMP-9 (–1562) C/C genotype was more frequent in PA group than in healthy controls (81.4% versus 64.6%, p = 0.002); C/C genotype was more frequently present in PA females compared to healthy control females, 81.5% versus 64.6%, p = 0.018, as well. MMP-9 (–1562) C/C genotype was frequently observed for all subgroups: noninvasive and invasive, nonrecurrence, and inactive PA compared to healthy controls: 81.8% versus 64.6%, p = 0.021; 81.0% versus 64.6%, p = 0.041; 81.8% versus 64.6%, p = 0.005; 100.0% versus 64.6%, p < 0.001, respectively. MMP-9 (–1562) C/C genotype was more frequent in inactive PA compared to active PA: 100.0% versus 71.4%; p < 0.001. Conclusion. MMP-9 (–1562) C/C genotype plays a role in nonrecurrence, inactive, and invasive as well as in nonivasive PA development.
Collapse
|
13
|
Sasagawa Y, Tachibana O, Doai M, Hayashi Y, Tonami H, Iizuka H, Nakada M. Carotid artery protrusion and dehiscence in patients with acromegaly. Pituitary 2016; 19:482-7. [PMID: 27207439 DOI: 10.1007/s11102-016-0728-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE Acromegaly is a systemic disease which causes multiple bony alterations. Some authors reported that acromegalic patients have risk factors for an intraoperative vascular injury due to the specific anatomical features of their sphenoid sinus. The objective of our study was to analyze the anatomic characteristics of sphenoid sinus in acromegalic patients compared with controls, by evaluation of computed tomography (CT) findings. METHODS We examined 45 acromegalic (acromegaly group) and 45 non-acromegalic patients (control group) with pituitary adenomas who were matched for sex, age, height, tumor size, and cavernous sinus invasion (Knosp grade). Preoperative CT of the pituitary region including the sphenoid sinus was used to evaluate the following anatomic characteristics: type of sphenoid sinus (sellar or pre-sellar/conchal); intrasphenoid septa (non/single or multiple); carotid artery protrusion; carotid artery dehiscence; intercarotid distance. RESULTS Sixteen acromegalic patients (35.5 %) and 6 controls (13.3 %) had carotid artery protrusion. Additionally, 10 acromegalic patients (22.2 %) and 3 controls (6.6 %) had carotid artery dehiscence. Carotid artery protrusion and dehiscence were more frequent in the acromegaly group than in control group (p = 0.013 and 0.035, respectively). Other anatomic characteristics (type of sphenoid sinus, intrasphenoid septa, and intracarotid distance) showed no significant differences between acromegaly and control groups. CONCLUSIONS Our study suggests that carotid artery protrusion and dehiscence occur more frequently among acromegalic patients, compared with non-acromegalic patients. It is important for surgeons to be aware of these anatomic variations to avoid vital complications, such as carotid injuries, during surgery.
Collapse
Affiliation(s)
- Yasuo Sasagawa
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Osamu Tachibana
- Department of Neurosurgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Mariko Doai
- Department of Diagnostic and Therapeutic Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Yasuhiko Hayashi
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hisao Tonami
- Department of Diagnostic and Therapeutic Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hideaki Iizuka
- Department of Neurosurgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| |
Collapse
|
14
|
Li S, Zhang Z, Xue J, Guo X, Liang S, Liu A. Effect of Hypoxia on DDR1 Expression in Pituitary Adenomas. Med Sci Monit 2015; 21:2433-8. [PMID: 26286316 PMCID: PMC4547544 DOI: 10.12659/msm.894205] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Pituitary adenoma is a common intracranial tumor in neurosurgery. Some pituitary adenomas have the characteristics of invasive growth make them unable to be removed completely by surgery leading to easy relapse. Discoidin domain receptor l (DDR1) is a new kind of tyrosine kinase receptor on the cell surface. DDR1 can be activated by tumor microenvironment signal in tumorigenesis, increasing MMP-2/9 expression and promoting the invasive ability of tumor cells. Anoxia can promote tumor growth and metastasis. This study investigated the impact of anoxic environment DDR1 expression in pituitary adenoma. Material/Methods A primary hypoxia pituitary adenoma cell model was established and treated with DDR1 inhibitor nilotinib. Real-time PCR and Western blot were used to detect DDR1 mRNA and protein expression. ELISA was used to detect MMP-2/9 changes. MTT method was used to detect pituitary adenoma cell proliferation. We used a transwell chamber to determine pituitary adenoma cell invasion ability. Results DDR1 mRNA and protein were significantly overexpressed under hypoxia (P<0.05). MMP-2 and MMP-9 expression was obviously increased in supernatant (P<0.05). Pituitary adenoma cell proliferation and invasive ability improved markedly under hypoxia (P<0.05). Nilotinib could reduce DDR1 expression, decrease MMP-2 and MMP-9 expression, and inhibit pituitary adenoma cells proliferation and invasion. Conclusions Hypoxia can increase DDR1 expression in pituitary adenoma cells, leading to improved MMP-2 and MMP-9 secretion, and promoting pituitary adenoma cell proliferation and invasion.
Collapse
Affiliation(s)
- Shouchun Li
- Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital, Bejing, China (mainland)
| | - Zhiwen Zhang
- Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital, Bejing, China (mainland)
| | - Jinghui Xue
- Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital, Bejing, China (mainland)
| | - Xiaoming Guo
- Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital, Bejing, China (mainland)
| | - Shuli Liang
- Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital, Bejing, China (mainland)
| | - Aijun Liu
- Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital, Bejing, China (mainland)
| |
Collapse
|
15
|
Wang M, Zhang H, Heng X, Pang Q, Sun A. Expression of cold-inducible RNA-binding protein (CIRP) in pituitary adenoma and its relationships with tumor recurrence. Med Sci Monit 2015; 21:1256-60. [PMID: 25934796 PMCID: PMC4428314 DOI: 10.12659/msm.893128] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The aim of this study was to detect the expression of cold-inducible RNA-binding protein in pituitary adenoma and to determine its effects on tumor recurrence. MATERIAL/METHODS We collected a total of 60 post-op samples collected from pituitary adenoma patients (including 20 cases of invasive pituitary adenoma, 20 cases of non-invasive adenoma, and 20 cases of non-invasive recurrent adenoma) admitted in our hospital. Both protein and mRNA levels of CIRP in 3 types of pituitary adenoma samples were quantified by Western blotting and real-time PCR, respectively. RESULTS Western blotting revealed significantly elevated CIRP expression levels in invasive pituitary adenoma compared to non-invasive tumors, with statistical significance (p<0.05). Recurrent pituitary adenoma expressed significantly higher CIRP levels compared to non-recurrent tumors (p<0.05). Real-time PCR for CIRP mRNA obtained consistent results: transcript levels were significantly higher in invasive pituitary adenoma compared to non-invasive adenoma (p<0.05); recurrent adenoma also had significantly higher CIRP mRNA levels compared to non-recurrent tumors (p<0.05). Among all 3 types of pituitary adenoma, recurrent tumors had the highest levels of CIRP mRNA and protein. CONCLUSIONS The expression of CIRP in pituitary adenoma is closely related with tumor proliferation and invasion, and its significantly elevated expression level indicates post-op recurrence.
Collapse
Affiliation(s)
- Mingguang Wang
- Department of Neurosurgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
- Department of Neurosurgery, People’s Hospital of Linyi, Linyi, Shandong, P.R. China
| | - Huan Zhang
- Department of Neurosurgery, People’s Hospital of Linyi, Linyi, Shandong, P.R. China
| | - Xueyuan Heng
- Department of Neurosurgery, People’s Hospital of Linyi, Linyi, Shandong, P.R. China
| | - Qi Pang
- Department of Neurosurgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Aigang Sun
- Department of Neurosurgery, People’s Hospital of Linyi, Linyi, Shandong, P.R. China
- Corresponding Author: Aigang Sun, e-mail:
| |
Collapse
|