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. 2016 Jun 1;12(3):576-86.
doi: 10.5114/aoms.2016.59932. Epub 2016 May 18.

Three-dimensional reconstruction and morphological characterization of pituitary macroadenomas

Shou-Sen Wang  1 , Lin Wei  1 , Jun-Jie Jing  1 , Shang-Ming Zhang  1
Affiliations

Three-dimensional reconstruction and morphological characterization of pituitary macroadenomas

Shou-Sen Wang et al. Arch Med Sci. .

Abstract

Introduction: The aim was to investigate the relationship between the tumor (clinicopathologic and radiological) characteristics and the morphological parameters of pituitary macroadenoma or giant adenoma patients using a three-dimensional (3D) reconstructed model.

Material and methods: Magnetic resoanance imaging (MRI) was performed preoperatively; tumor grade was determined by the Knosp-Steiner classification and tumor morphology by the SIPAP classification. Pituitary adenomas and adjacent structures were reconstructed three-dimensionally by volume rendering.

Results: Fifty-two and 6 patients underwent surgery via the transnasal transsphenoidal or pterional approach, respectively. Knosp-Steiner grades I to IV adenomas were observed in 5.2%, 25.9%, 22.4% and 46.6% of the patients, respectively. The 3D model was reconstructed in all cases with superb delineation of tumor morphology and the spatial relationship between the tumor and adjacent tissues. Pituitary adenomas were categorized into intrasellar (13.8%), suprasellar (20.7%), infrasellar (17.2%), and lobulated adenomas (48.3%). Suprasellar adenomas had the smallest (2.27 ±3.22 cm(3)) and lobulated adenomas the largest volume (24.61 ±30.50 cm(3)). Intrasellar adenomas were all functioning, while 75%, 60% and 60.7%, respectively, of suprasellar, infrasellar and lobulated adenomas were nonfunctioning, with a significant association between tumor morphology and secretory function (p = 0.005).

Conclusions: Three-dimensional reconstruction of pituitary macroadenomas offers a simplified morphological classification of pituitary adenomas and may be helpful for neurosurgeons to categorize and characterize pituitary adenomas.

Keywords: 3D reconstruction; SIPAP classification; morphology; pituitary macroadenomas; volume rendering.

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Figures

Figure 1
Figure 1
Three-dimensional reconstruction of a lobulated pituitary macroadenoma. The original files were imported into the VR station (A) and data were prepared (B). C, D – Lobulated adenoma (light blue), the internal carotid artery (ICA) (red) and adjacent soft tissues were reconstructed. E – Tumor was outlined (blue) by artificial tracing of the contours of the tumor. F – The 3D reconstructed image of the ICA and the optic chiasma
Figure 2
Figure 2
Three-dimensional reconstruction of a pituitary macroadenoma. A – The 3D reconstructed image of pituitary macroadenoma (blue), the ICA (light red) and the optic chiasma (light brown). B – The 3D reconstructed image of pituitary macroadenoma (blue), the ICA (light red), the optic chiasma (light brown) and the cranium. C – Virtual determination of distance and angle via the transnasal transsphenoidal approach. D – Virtual simulation of the transcranial approach
Figure 3
Figure 3
Morphological classification of pituitary adenomas. A, B – Intrasellar adenoma, no extension of the tumor; C, D – suprasellar adenoma, the tumor bulges superiorly into the suprasellar cistern; E, F – infrasellar adenoma, the tumor penetrates inferiorly into the sphenoid sinus; G, H – lobulated adenoma, the tumor bulges upwards
See this image and copyright information in PMC

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