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Neuroradiology |
1 From the Departments of Neuroradiology (J.P.C., D.H.), Neurosurgery (C.D., M.J.), and Adult Radiology (L.B., P.B., L.M.), CHRU Bretonneau, 2 bis, Bd Tonnellé, 37044 Tours cedex, France; and the Laboratory of Anatomy, Faculté de Médecine, Tours, France (C.D.). From the 1998 RSNA scientific assembly. Received January 21, 1999; revision requested March 22; revision received July 15; accepted August 12. Address correspondence to J.P.C. (e-mail: cottier@med.univ-tours.fr).
PURPOSE: To define magnetic resonance (MR) imaging criteria for the diagnosis of cavernous sinus invasion by pituitary adenoma.
MATERIALS AND METHODS: The MR images obtained in 106 patients (86 female, 20 male; age range, 16–71 years) were reviewed retrospectively by two physicians. The standard-of-reference criteria for invasion were the surgical findings. A 
2 analysis was performed, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for nine groups of MR imaging signs were computed.
RESULTS: Invasion of the cavernous sinus was certain (PPV, 100%) if the percentage of encasement of the internal carotid artery (ICA) by tumor was 67% or greater. It was highly probable if the carotid sulcus venous compartment was not depicted (PPV, 95%) or the line joining the lateral wall of the intracavernous and supracavernous ICAs was passed by the tumor (PPV, 85%). It was definitely not invaded (NPV, 100%) if the percentage of encasement of the intracavernous ICA was lower than 25% or the line joining the medial wall of the intracavernous and supracavernous ICAs was not passed by the tumor.
CONCLUSION: The radiologic diagnosis of cavernous sinus invasion by pituitary adenoma remains difficult, but the above-mentioned criteria may be of assistance.
Index terms: Cavernous sinus, 1767.38 • Cavernous sinus, MR, 1767.12141, 1767.12143 • Pituitary, MR, 145.12141, 145.12143 • Pituitary, neoplasms, 145.372
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