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The suprasellar volume of nonfunctioning pituitary adenomas: a useful tool for predicting visual field deficits

无功能垂体腺瘤的鞍上体积: 预测视野缺陷的有用工具

  • 影响因子:3.03
  • DOI:10.1007/s11102-020-01060-0
  • 作者列表:"Bonomo, Giulio","Bertani, Giulio A.","Carrabba, Giorgio G.","Ferrante, Emanuele","Pluderi, Mauro","Guastella, Claudio","Pignataro, Lorenzo","Rampini, Paolo","Mantovani, Giovanna","Locatelli, Marco
  • 发表时间:2020-06-19
Abstract

Purpose The aim of the present study is to assess the predictive value of the suprasellar volume (SSV) of nonfunctioning pituitary adenomas (NFPAs) for visual field (VF) impairment in order to guide clinical decision-making and improve neurosurgical management. Methods Two independent samples of patients with NFPAs (exploratory population N = 50, testing population N = 98) were included in the present study. In the first phase, we determined the optimal cut-off value of the SSV correlating with VF deficits in the exploratory population. In the second phase, we then studied the accuracy of identified cut-off in predicting a VF deficit in the testing population. Results In the exploratory population, the optimal cut-off value of the SSV to determine the presence of a VF deficit was 1.5 mL. Sensitivity and specificity of the cut-off were 81.3 and 100%, respectively. The positive predictive value (PPV) and the negative predictive value (NPV) were 100 and 75%, respectively. When we checked the identified cut-off score on the testing population, we found a sensitivity of 71% and a specificity of 100%. The PPV and NPV were 100 and 59.2%, respectively. In six cases with VF defects and SSV inferior to 1.5 mL, the displacement of optic chiasm was in superior position. Conclusion The SSV may represent an accurate method in routinely clinical practice for predicting VF deficit in patients affected by NFPA.

摘要

目的: 本研究的目的是评估鞍上体积 (SSV) 对无功能垂体腺瘤 (NFPAs) 视野 (VF) 的预测价值。损伤,以指导临床决策,提高神经外科管理水平。方法纳入 NFPAs 患者的 2 个独立样本 (探索性人群 n = 50,检测人群 n = 98)。在第一阶段,我们确定了探索人群中与 VF 缺陷相关的 SSV 的最佳临界值。在第二阶段,我们然后研究了在预测检测人群中 VF 赤字时确定的临界值的准确性。结果在探索性人群中,SSV 确定 VF 缺陷存在的最佳临界值为 1.5 mL。临界值的敏感性和特异性分别为 81.3 和 100%。阳性预测值 (PPV) 为 100,阴性预测值 (NPV) 为 75%。当我们在检测人群上检查确定的截止评分时,我们发现灵敏度为 71%,特异性为 100%。PPV 和 NPV 分别为 100 和 59.2%。6 例 VF 缺损,SSV 低于 1.5 mL,视交叉移位位置优越。结论 SSV 可能是常规临床实践中预测 NFPA 患者 VF 缺陷的准确方法。

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