SKULL

Question 1

MRI grading system for the pituitary tumor five grades and two subtypes, based on the tumor size and its influence on the surrounding tissue

Answer 1

• Grade 1: No tumor extension beyond the dorsum sellae
• Grade 2: Tumor extension beyond the dorsum sellae up to the third ventricle but no contact with the optic chiasm and mammillary body
• Grade 3: Tumor extension beyond the dorsum sellae up to the third ventricle and contact with the optic chiasm and/or mammillary body but without interthalamic adhesion
• Grade 4: Tumor extension beyond the dorsum sellae and contact with the optic chiasm, mammillary body and interthalamic adhesion
• Grade 5: Tumor occupation of the third ventricle.
• • Type A referring to cases without involvement of the cavernous sinus and/or arterial circle of Willis
• Type B referring to cases with involvement of either or both.

Question 2

TRANSSPHENOIDAL SURGERY: ADENOMA SIZE

Answer 2

• Netherlands group (n=306), 0.13–1.40 (median, 0.39)
• US group (n=26), 0.35–1.54 (median, 0.73)
• Japan group (n=33), 0.23–0.83.29

the procedure can still be effective as a volume-reduction surgery for intracranial space-occupying lesions. Thus, pituitary adenoma size may not be necessarily the deciding factor for determining the suitability of surgery.

Question 3

Measurements of pituitary brain ratio (PBR).

PBR can be calculated by both CT and MRI.

Image that contained the largest cross section of the pituitary

Answer 3

• the edge of the brain (shown in blue line)= AREA
• height of the pituitary gland was measured (shown in yellow arrow).

PBR = (height of the pituitary gland)/(cross sectional area of the brain) x 10^2. (Dr. Kooistra HS in1997)

Question 4

Hanson et al TSS treatment for PDH in canines

Answer 4

• 127 cases of remission from among 150 cases (85%)
• 124 canines showing remission of HAC symptoms within 8 weeks of operation.
• The 1-, 2-, 3-, and 4-year survival rates after the TSS procedure were 83.5%, 76.1%, 71.5%, and 67.8%, respectively.