Objective To investigate the accuracy of volumetric measurements (Dotian formula and platform-like volume calculation formula [PLVCA]) in pituitary adenomas and their practicabilities.Methods Forty-five large and giant pituitary adenomas patients,admitted to our hospital from May 2013 to May 2014,were collected.According to the imaging finds of pituitary adenomas,the patients were divided into regular type group and irregular type group;the volume of these tumors were calculated by PLVCA method,Dotian formula and virtual reality (VR) reconstruction method,respectively.The results of VR method were used as the standards to investigate the accuracy of Dotian formula and PLVCA method on pituitary adenomas.Results In 45 pituitary adenomas,17 (37.78％) were regular;the result of tumor volume using VR method was (6.54±11.27) cm3,that using PLVCA method was (5.50±9.40) cm3 and that using Dotian formula was (4.32±9.00) cm3;significant differences were noted between the results of VR method and PLVCA method and the results of VR method and Dotian formula (P＜0.05);there was no significant difference between the results of PLVCA method and Dotian formula (P＞0.05).Another 28 (62.22％) were irregular;the result of volume using VR method was (11.65±16.60) cm3,that using PLVCA method was (11.50±16.18) cm3,there was no significant difference between the two results (P＞0.05);that using Dorian formula was (10.04±19.45) cm3,and there was significant difference between the VR method and Dotan formula (P＜0.05),which was also found between PLVCA method and Tada formula (P＜0.05).Conclusion PLVCA method has a higher accuracy in volume measurement of pituitary adenomas than Dotian formula,especially in irregular adenomas.

Objective To observe and measure the morphology of diaphragm sella under MR imaging and its parameters in patients with pituitary adenoma,and to explore its clinical significance.Methods Forty-seven patients with pituitary adenoma,admitted to our hospital from March 2012 to April 2013,were collected in our study; the traditional MR imaging of all patients were obtained preoperatively and postoperatively,and 3D-GE sequence scanning was added preoperatively.The parameters of diaphragm sella were measured and compared between patients existed invasion and without invasion,and between patients enjoyed total resection and non-total resection; and the correlation between each two parameters were analyzed.Results Concave,horizontal and convex diaphragm sellae (n=3,10 and 34,respectively) were observed; tumor height of the patients whose diaphragm sella was convex was significantly higher than that of the concave cases ([28.82±11.29] mm vs.[13.57±4.42]mm,P＜0.05).The size and elevation angle of the diaphragmal opening were positively correlated with tumor height (r=0.224,P=0.003; r=0.586,P=0.000).The size ofdiaphragmal opening in the invasive group was significantly larger than that in non-invasive group ([10.30±5.79] mm vs.[5.55 ±3.29] mm,P=0.002).The size of diaphragmal opening in non-total resection group was significantly greater than that in the total resection group ([5.58±4.14] mmvs.[11.04±4.80] mm,P=0.000),and the width of diaphragrnal opening was negatively correlated with tumor resection ratio (r=-0.576,P=0.020).Conclusions Diaphragrna sellae could be displayed satisfactorily in contrast-enhanced 3D-GE MRI.The size of the diaphragmal opening and the elevated angle of drua besides diaphragrnal opening are positively correlated with tumor height.The size of diaphragmal opening of the invasive pituitary adenoma patients is larger than that ofnon-invasive ones.The larger the diaphragrnal opening size,the more difficult the tumor being totally resected by transsphenoidal approach.

Objective To compare the therapeutic efficacy of giant nonfunctioning pituitary adenomas (GNPAs) of different imaging types,and to explore the surgical treatment strategies of GNPAs.Methods The pre-and post-operative images,clinical data and follow-up results of 69 patients with GNPAs,admitted to our hospital from July 2011 to October 2016,were analyzed retrospectively.According to the morphology and growth patterns of tumors on MR imaging,they were divided into GNPAs of vertical type,cystic type,deviation Ⅰ/Ⅱ type,lateral extension type,sinus type,laryngeal type,isolated type,and mixed type.The tumor resection results of GNPAs of different types were compared by different surgical treatment strategies.Results Fifty-one patients,with total resection rate of 31.37％,were treated by transsphenoidal approach,and 18 patients,total resection rate of 44.44％,were treated by craniotomy.The overall total resection rate of GNPAs was 36.23％ (n=25).Total resection rate and subtotal resection rate was 71.01％ (n=49).The surgery resection rates of GNPAs of different types were different,and the GNPAs of mixed type enjoyed the worst efficacy.Fifty-three patients were followed-up for one-66 months with an average of 17 months;in patients with total resection,18 (72％) were without recurrence,one (4％) was with recurrence;X knife treatment was performed in 14 patients.Postoperative residual reduction,control,and increase were noted in 4,26 and 4 patients.Two patients died after surgery.Conclusions The total reduction rate of GNPAs is low and the operation is difficult;however,favorable prognosis can be achieved.Transsphenoidal surgery is the first choice for elimination of occupying effect.According to different types,appropriate procedures can be used to reduce the tumor residue and improve the total resection or subtotal rates.