Analysis of the Intercavernous Sinus in Sellar Lesions Using Multidetector Computed Tomography Digital Subtraction Venography

World Neurosurg. 2016 Feb:86:336-40. doi: 10.1016/j.wneu.2015.08.079. Epub 2015 Sep 4.

Abstract

Objective: The intercavernous sinuses (ICSs) connect the cavernous sinuses on both sides. Although the management of ICSs is an important aspect in extended transsphenoidal surgery (eTSS), there has been no report to evaluate ICSs in sellar lesions. In this study, we analyzed ICSs using computed tomographic digital subtraction venography (CT-DSV) in sellar lesions.

Methods: We retrospectively analyzed ICSs in 52 cases of pituitary adenoma and 13 cases of tuberculum sellae meningioma using CT-DSV.

Results: In pituitary adenomas, the detection rate of ICSs was lower than that of normal sellae controls. When the tumor volume of pituitary adenomas was greater than 5 ml, we could not detect any ICSs. In tuberculum sellae meningiomas, the detection rate of the anterior intercavernous sinus was high, but this finding was not significant. Meningioma tumor sizes did not have any influence on ICSs.

Conclusion: CT-DSV can be useful for evaluating ICSs in sellar lesions. Preoperative evaluation of ICSs may provide important information for eTSS.

Keywords: Intercavernous sinus; Pituitary adenoma; Transsphenoidal surgery; Tuberculum sellae meningioma.

MeSH terms

  • Adenoma / diagnosis
  • Adenoma / pathology*
  • Adenoma / surgery
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction / methods*
  • Cavernous Sinus / pathology
  • Cavernous Sinus / surgery
  • Cranial Sinuses / pathology*
  • Cranial Sinuses / surgery
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Meningioma / surgery
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Phlebography
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / pathology*
  • Pituitary Neoplasms / surgery
  • Preoperative Period
  • Sella Turcica / pathology*
  • Sella Turcica / surgery
  • Sphenoid Sinus / pathology
  • Sphenoid Sinus / surgery
  • Young Adult