• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Doctoral Thesis
DOI
10.11606/T.5.2004.tde-13102014-092603
Document
Author
Full name
Joaquim Oliveira Vieira Junior
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2004
Supervisor
Committee
Cukiert, Arthur (President)
Marchiori, Paulo Euripedes
Silva, Maria Elizabeth Rossi da
Abucham Filho, Júlio Zaki
Lengyel, Ana Maria Judith
Title in Portuguese
Avaliação dos critérios de invasão do seio cavernoso nas imagens de ressonância magnética de adenomas hipofisários: utilização da regressão logística na análise estatística e correlação dos exames com os achados cirúrgicos
Keywords in Portuguese
Estudos retrospectivos
Imagem por ressonância magnética/métodos
Modelos logísticos
Neoplasias hipofisárias/cirurgia
Seio cavernoso/patologia
Abstract in Portuguese
O objetivo do autor neste trabalho foi definir critérios pré-operatórios de invasão do seio cavernoso em imagens de Ressonância Magnética (RM) de pacientes com adenomas hipofisários. Neste estudo retrospectivo, foram revisadas as imagens de RM de 103 pacientes com adenomas hipofisários tratados cirurgicamente (48 com invasão do seio cavernoso) e compararam 8 sinais de imagem com os achados cirúrgicos (critério de referência para invasão). A análise estatística foi realizada utilizando o teste de qui-quadrado (X2), e a sensibilidade, especificidade, valor preditivo positivo(VPP) e valor preditivo negativo (VPN) foram obtidos para cada grupo de sinais. Também foram calculados, por regressão logística, os valores de "odds ratio" dos critérios mais significativos, e realizada a regressão logística múltipla para análise conjunta desses critérios. O seio cavernoso não estava invadido com certeza quando: a glândula hipofisária normal estava interposta entre ele e o adenoma (VPP, 100%); o compartimento venoso medial foi visibilizado (VPP, 100%); a porcentagem de envolvimento carotídeo pelo tumor foi menor que 25% (VPN, 100%) e o tumor não cruzava a linha intercarotídea medial (VPN, 100%). A invasão do seio cavernoso era certa (VPP, 100%) se: a porcentagem de envolvimento carotídeo era igual ou maior que 45%; 3 ou mais compartimentos venosos não eram visibilizados e o compartimento venoso lateral não era visibilizado. A presença de invasão era altamente sugestiva quando: o compartimento venoso inferior não era visibilizado (VPP, 92,8%); o tumor cruzava a linha intercarotídea lateral (VPP, 96,1%) e quando a parede dural lateral do seio cavernoso estava abaulada (VPP, 92,3%). Na análise conjunta, o critério com maior significância estatística para invasão foi o envolvimento carotídeo pelo adenoma > 30%
Title in English
Evaluation of cavernous sinus invasion criteria in Magnetic Resonance Imaging (MRI) of pituitary adenomas: utilization of the logistic regression in the statistical analysis and correlation of the images with the surgical findings
Keywords in English
Cavernous sinus/pathology
Logistic regression
Magnetic resonance imaging/methods
Pituitary adenoma/surgery
Retrospective studies
Abstract in English
The author's objective in this study was to define preoperative MRI criteria of cavernous sinus invasion by pituitary adenoma. In this retrospective study, the authors reviewed the MR images of 103 patients with pituitary adenomas treated surgically (48 with cavernous sinus invasion) and compared 8 groups of MR imaging signs with the surgical findings (the standard of reference criterion for invasion). Statistical analysis was performed using a qui-square test (X2), and the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were obtained for each group of signs. The odds ratio of the most significant criteria was also obtained and the multiple logistic regression test was used to evaluate the criteria all together. The cavernous sinus was definitely not invaded when: normal pituitary gland was interposed between the adenoma and it (PPV, 100%); the medial venous compartment was depicted (PPV, 100%); the percentage of encasement of the intracavernous internal carotid artery (ICA) was lower than 25% (NPV, 100%) and the medial intercarotid line was not crossed (NPV, 100%). Invasion of the cavernous sinus was certain (PPV, 100%) if: the percentage of encasement of the intracavernous ICA was 45% or greater and three or more venous compartment or the lateral venous compartment was not depicted. It was highly probable invaded if: the inferior venous compartment was not depicted (PPV, 92,8%); the lateral intercarotid line was crossed (PPV, 96,1%) and the lateral dural wall of the cavernous sinus was bulged (PPV, 92,3%). The most valuable criterion of cavernous sinus invasion by statistical analysis was the percentage of encasement of intracavernous ICA >30%.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2014-10-13
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
Centro de Informática de São Carlos
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2019. All rights reserved.