Management protocol and surgical techniques for MRI–Negative Cushing’s disease: a series of 6 cases

Up to 40% of Cushing’s disease (CD) patients show no evidence of an adenoma on dynamic contrast-enhanced MRI. Inferior petrosal sinus sampling (IPSS) remains the gold standard for diagnosis in these patients. Remission rates in MRI–Negative CD are far less at 50%–71%, compared with patients in whom...

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Autores principales: Sadhwani, Nidhisha, Suri, Ashish, Raheja, Amol, Bora, Santanu Kumar, Khadgawat, Rajesh, Sharma, Mehar Chand, Garg, Ajay, Sharma, Rajni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association of Neurological Surgeons 2023
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10321547/
https://www.ncbi.nlm.nih.gov/pubmed/37416811
http://dx.doi.org/10.3171/2023.4.FOCVID2318
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author Sadhwani, Nidhisha
Suri, Ashish
Raheja, Amol
Bora, Santanu Kumar
Khadgawat, Rajesh
Sharma, Mehar Chand
Garg, Ajay
Sharma, Rajni
author_facet Sadhwani, Nidhisha
Suri, Ashish
Raheja, Amol
Bora, Santanu Kumar
Khadgawat, Rajesh
Sharma, Mehar Chand
Garg, Ajay
Sharma, Rajni
author_sort Sadhwani, Nidhisha
collection PubMed
description Up to 40% of Cushing’s disease (CD) patients show no evidence of an adenoma on dynamic contrast-enhanced MRI. Inferior petrosal sinus sampling (IPSS) remains the gold standard for diagnosis in these patients. Remission rates in MRI–Negative CD are far less at 50%–71%, compared with patients in whom an adenoma is identified on MRI. Endoscopic endonasal transsphenoidal surgery is the surgical approach of choice in these cases. Various adjuncts can be used to localize an adenoma. In this video, the authors highlight their additional usage of pituitary perfusion MRI for identification of the adenoma. They present their stepwise management algorithm and surgical techniques for sellar and suprasellar exploration in 6 cases of MRI–Negative CD operated on by the senior author (A.S.). The video can be found here: https://stream.cadmore.media/r10.3171/2023.4.FOCVID2318
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spelling pubmed-103215472023-07-06 Management protocol and surgical techniques for MRI–Negative Cushing’s disease: a series of 6 cases Sadhwani, Nidhisha Suri, Ashish Raheja, Amol Bora, Santanu Kumar Khadgawat, Rajesh Sharma, Mehar Chand Garg, Ajay Sharma, Rajni Neurosurg Focus Video Article Up to 40% of Cushing’s disease (CD) patients show no evidence of an adenoma on dynamic contrast-enhanced MRI. Inferior petrosal sinus sampling (IPSS) remains the gold standard for diagnosis in these patients. Remission rates in MRI–Negative CD are far less at 50%–71%, compared with patients in whom an adenoma is identified on MRI. Endoscopic endonasal transsphenoidal surgery is the surgical approach of choice in these cases. Various adjuncts can be used to localize an adenoma. In this video, the authors highlight their additional usage of pituitary perfusion MRI for identification of the adenoma. They present their stepwise management algorithm and surgical techniques for sellar and suprasellar exploration in 6 cases of MRI–Negative CD operated on by the senior author (A.S.). The video can be found here: https://stream.cadmore.media/r10.3171/2023.4.FOCVID2318 American Association of Neurological Surgeons 2023-07-01 /pmc/articles/PMC10321547/ /pubmed/37416811 http://dx.doi.org/10.3171/2023.4.FOCVID2318 Text en © 2023, The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the CC BY license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Sadhwani, Nidhisha
Suri, Ashish
Raheja, Amol
Bora, Santanu Kumar
Khadgawat, Rajesh
Sharma, Mehar Chand
Garg, Ajay
Sharma, Rajni
Management protocol and surgical techniques for MRI–Negative Cushing’s disease: a series of 6 cases
title Management protocol and surgical techniques for MRI–Negative Cushing’s disease: a series of 6 cases
title_full Management protocol and surgical techniques for MRI–Negative Cushing’s disease: a series of 6 cases
title_fullStr Management protocol and surgical techniques for MRI–Negative Cushing’s disease: a series of 6 cases
title_full_unstemmed Management protocol and surgical techniques for MRI–Negative Cushing’s disease: a series of 6 cases
title_short Management protocol and surgical techniques for MRI–Negative Cushing’s disease: a series of 6 cases
title_sort management protocol and surgical techniques for mri–negative cushing’s disease: a series of 6 cases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10321547/
https://www.ncbi.nlm.nih.gov/pubmed/37416811
http://dx.doi.org/10.3171/2023.4.FOCVID2318
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