Objective To evaluate magnetic resonance imaging(MRI)characteristics and surgical results of adrenocorticotropin(ACTH)-secreting pituitary adenomas.Methods MRI characteristics and relationship between MRI positive rat...Objective To evaluate magnetic resonance imaging(MRI)characteristics and surgical results of adrenocorticotropin(ACTH)-secreting pituitary adenomas.Methods MRI characteristics and relationship between MRI positive rate and surgical results of 266 patients with pathologically confirmed Cushing's disease were analyzed retrospectively.All patients underwent thin-section sagittal and coronal scans of the pituitary gland before and after administration of gadolinium-diethylene triamine pentaacetic acid(Gd-DTPA)on a 1.5 Tesla MRI scanner,and dynamic enhanced MRI was performed in 39 patients.All patients underwent transsphenoidal adenomectomy.Endocrinological examinations and assessments were performed.Results Preoperative MRI revealed normal results in 41(15.4%)cases,microadenoma in 179(67.3%),macroadenoma in 42(15.8%),and huge adenoma in 4(1.5%).Pituitary apoplexy was found in 13(4.9%)cases.Positive rate of ACTH-secreting adenomas was 84.6%(225/266)on MRI scans,and that of small microadenomas was 87.2%(34/39)on dynamic enhanced MRI scans.Preoperative endocrinological tests of 199 cases supported the diagnosis of typical Cushing's disease,while the other 67 cases had atypical endocrinological results.The endocrinological cure rate,remission rate,and inefficacy rate were 85.7%,7.9%,and 6.4%,respectively.There was no difference in the initial endocrinological cure rate between the patients with positive and normal MRI results(90% vs.87.8%,P=0.904).Conclusions Enhanced coronal pituitary MRI is helpful for preoperative localization of ACTH-secreting pituitary microadenoma.Dynamic enhanced MRI may improve detection rate of microadenoma.There is no marked difference in the surgical results for patients with preoperative MRI results indicating presence or absence of microadenoma.展开更多
目的:探讨褪黑素(MLT)对足部电击所致创伤后应激障碍(PTSD)大鼠下丘脑-垂体-肾上腺(HPA)轴的影响。方法:利用足底电击法制备大鼠PTSD模型,通过腹腔注射方法给予治疗组大鼠MLT。通过拒俘反应测试检测大鼠的行为学变化,利用real time RT-...目的:探讨褪黑素(MLT)对足部电击所致创伤后应激障碍(PTSD)大鼠下丘脑-垂体-肾上腺(HPA)轴的影响。方法:利用足底电击法制备大鼠PTSD模型,通过腹腔注射方法给予治疗组大鼠MLT。通过拒俘反应测试检测大鼠的行为学变化,利用real time RT-PCR方法检测下丘脑中促肾上腺皮质激素释放激素(CRH)mRNA的表达,利用酶联免疫吸附试验(ELISA)检测血清中促肾上腺皮质激素(ACTH)、肾上腺素(EPI)和糖皮质激素(GC)的含量。结果:PTSD组大鼠拒俘反应明显(P<0.05),下丘脑中CRH mRNA表达升高(P<0.05),血清中ACTH和EPI明显升高(P<0.05),但是GC水平下降(P<0.05)。MLT治疗后可以明显缓解PTSD大鼠拒俘反应(P<0.05),同时降低下丘脑中CRH mRNA表达(P<0.05),降低血清中ACTH和EPI水平并升高GC的水平(P<0.05)。结论:MLT治疗可缓解PTSD大鼠的症状,并恢复HPA轴的神经内分泌平衡。展开更多
文摘Objective To evaluate magnetic resonance imaging(MRI)characteristics and surgical results of adrenocorticotropin(ACTH)-secreting pituitary adenomas.Methods MRI characteristics and relationship between MRI positive rate and surgical results of 266 patients with pathologically confirmed Cushing's disease were analyzed retrospectively.All patients underwent thin-section sagittal and coronal scans of the pituitary gland before and after administration of gadolinium-diethylene triamine pentaacetic acid(Gd-DTPA)on a 1.5 Tesla MRI scanner,and dynamic enhanced MRI was performed in 39 patients.All patients underwent transsphenoidal adenomectomy.Endocrinological examinations and assessments were performed.Results Preoperative MRI revealed normal results in 41(15.4%)cases,microadenoma in 179(67.3%),macroadenoma in 42(15.8%),and huge adenoma in 4(1.5%).Pituitary apoplexy was found in 13(4.9%)cases.Positive rate of ACTH-secreting adenomas was 84.6%(225/266)on MRI scans,and that of small microadenomas was 87.2%(34/39)on dynamic enhanced MRI scans.Preoperative endocrinological tests of 199 cases supported the diagnosis of typical Cushing's disease,while the other 67 cases had atypical endocrinological results.The endocrinological cure rate,remission rate,and inefficacy rate were 85.7%,7.9%,and 6.4%,respectively.There was no difference in the initial endocrinological cure rate between the patients with positive and normal MRI results(90% vs.87.8%,P=0.904).Conclusions Enhanced coronal pituitary MRI is helpful for preoperative localization of ACTH-secreting pituitary microadenoma.Dynamic enhanced MRI may improve detection rate of microadenoma.There is no marked difference in the surgical results for patients with preoperative MRI results indicating presence or absence of microadenoma.
文摘目的:探讨褪黑素(MLT)对足部电击所致创伤后应激障碍(PTSD)大鼠下丘脑-垂体-肾上腺(HPA)轴的影响。方法:利用足底电击法制备大鼠PTSD模型,通过腹腔注射方法给予治疗组大鼠MLT。通过拒俘反应测试检测大鼠的行为学变化,利用real time RT-PCR方法检测下丘脑中促肾上腺皮质激素释放激素(CRH)mRNA的表达,利用酶联免疫吸附试验(ELISA)检测血清中促肾上腺皮质激素(ACTH)、肾上腺素(EPI)和糖皮质激素(GC)的含量。结果:PTSD组大鼠拒俘反应明显(P<0.05),下丘脑中CRH mRNA表达升高(P<0.05),血清中ACTH和EPI明显升高(P<0.05),但是GC水平下降(P<0.05)。MLT治疗后可以明显缓解PTSD大鼠拒俘反应(P<0.05),同时降低下丘脑中CRH mRNA表达(P<0.05),降低血清中ACTH和EPI水平并升高GC的水平(P<0.05)。结论:MLT治疗可缓解PTSD大鼠的症状,并恢复HPA轴的神经内分泌平衡。
