Navegando por Palavras-chave "Consistency"

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    Adenomas hipofisários: relação entre achados de imagem na Ressonância Magnética (RM), consistência cirúrgica e anatomia patológica
    (Universidade Federal de São Paulo (UNIFESP), 2021) Gaia, Felipe Franco Pinheiro [UNIFESP]; Cruz, Oswaldo Laercio Mendonca [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Trans-sphenoid surgery for pituitary adenomas is the most frequent option for the treatment of these tumors today. The intraoperative difficulty in this technique depends a lot on the consistency of the tumor and the literature does not provide clear subsidies for the measurement of tumor consistency in preoperative planning and, consequently, on the degree of surgical difficulty. Objective: To perform a comprehensive literature review on pituitary adenomas and their consistency assessed by magnetic resonance imaging, intraoperative consistency and their correlation with histopathology (collagen and reticulin). Based on the results obtained in this review, to develop a prospective study in an attempt to establish an imaging study protocol that can safely predict tumor consistency prior to surgery. Methods: Literature review through the Medline database. In parallel, from November 2017 to July 2019, prospectively studied patients diagnosed with pituitary adenoma who underwent surgical resection by trans-sphenoidal endoscopy. A total of 15 patients were operated on, 5 of wich were used to exemplify the method. All patients underwent magnetic resonance imaging, intraoperative consistency and collagen and reticulin quantification by fractal analysis. Results: Literature data are still insufficient to define if there was a relationship between imaging findings and tumor consistency, predicting the degree of intraoperative difficulty. Five surgical cases studied provided the definition and validation of a magnetic resonance study protocol for this purpose. Conclusion: There is not yet in literature an imaging protocol capable of reliably predicting the consistency of pituitary adenomas. Thus, through the analysis of Imaging (MRI), Surgery and Histopathology data, we propose an MRI imaging protocol in an attempt to reduce bias and better predict tumor consistency prior to surgery.