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Morphometric Study of the Korean Adult Pituitary Glands and the Diaphragma Sellae

  • Ju, Kyo-Sung (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Bae, Hack-Gun (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Park, Hyung-Ki (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Chang, Jae-Chil (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Choi, Soon-Kwan (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Sim, Ki-Bum (Department of Neurosurgery, Jeju National University)
  • 발행 : 2010.01.28

초록

Objective: To investigate the morphometric characteristics of the pituitary gland and diaphragma sellae in Korean adults. Methods: Using the 33 formaline fixed adult cadavers (23 male, 10 female), the measurements were taken at the diaphragma sellae and pituitary gland. The authors investigated the relationship between dura and structures surrounding pituitary gland, morphometric aspects of pituitary gland and stalk, and morphometric aspect of central opening of diaphragma sellae. Results: The boundary between the lateral surface of pituitary gland and the medial wall of cavernous sinus was formed by the thin dural layer and pituitary capsule. The pituitary capsule adherent tightly to the pituitary gland was observed to continue from the diaphragma sellae. Mean width, length, and height of the pituitary gland were 14.3${\pm}$2.1, 7.9${\pm}$1.3, and 6.0${\pm}$0.9 mm in anterior lobes, and 8.7${\pm}$1.7, 2.9${\pm}$1.1, and 5.8${\pm}$1.0 mm in posterior lobes, respectively. Although all dimensions of anterior lobe in female were slightly larger than those in male, statistical significance was noted in only longitudinal dimension. The ratio of posterior lobe to the whole length of pituitary gland was about 27%. The mean thickness of pituitary stalk was 2 mm. The diaphragmal opening was 5 mm or more in 26 (78.8%) of 33 specimen. The opening was round in 60.6% of the specimen, and elliptical oriented in an anterior-posterior or transverse direction in 39.4%. Conclusion: These results provide the safe anatomical knowledge during the transsphenoidal surgery and may be helpful to access the possibility of the development of empty sella syndrome.

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참고문헌

  1. Amar AP, Weiss MH : Pituitary anatomy and physiology. Neurosurg Clin N Am 14 : 11-23, 2003 https://doi.org/10.1016/S1042-3680(02)00017-7
  2. Aron DC, Findling JW, Tyrell JB : Hypothalamus and pituitary in Greenspan FS, Strewler GJ (eds) : Basic and clinical endocrinology, ed 5. Stanford : Appleton & Lange, 1997, pp95-156
  3. Bergland RM, Ray BS, Torack RM : Anatomical variations in the pituitary gland and adjacent structures in 225 human autopsy cases. J Neurosurg 28 : 93-99, 1968 https://doi.org/10.3171/jns.1968.28.2.0093
  4. Campero A, Martins C, Yasuda A, Rhoton AL Jr : Microsurgical anatomy of the diaphragma sellae and its role in directing the pattern of growth of pituitary adenomas. Neurosurgery 62 : 717-723; discussion 717-723, 2008 https://doi.org/10.1227/01.neu.0000317321.79106.37
  5. Dietemann JL, Kehrli P, Maillot C, Diniz R, Reis M Jr, Neugroschl C, et al. : Is there a dural wall between the cavernous sinus and the pituitary fossa? Anatomical and MRI findings. Neuroradiology 40 : 627-630, 1998 https://doi.org/10.1007/s002340050653
  6. Elster AD, Chen MY, Williams DW 3rd, Key LL : Pituitary gland : MR imaging of physiologic hypertrophy in adolescence. Radiology 174 : 681-685, 1990
  7. Kimmel DW, O'Neill BP : Systemic cancer presenting as diabetes insipidus. Clinical and radiological features of 11 patients with a review of metastatic-induced diabetes insipidus. Cancer 52 : 2355-2358, 1983 https://doi.org/10.1002/1097-0142(19831215)52:12<2355::AID-CNCR2820521232>3.0.CO;2-J
  8. Kirgis HD, Locke W : Anatomy and embryology in Locke W, Schally AV (eds) : The hypothalamus and pituitary in health and disease. Charles C. Thomas : Spring-field, 1972, pp3-65
  9. Puig ML, Webb SM, Del Pozo C, de Juan M, Serrano S, Vilardell E : Endocrine aspects of pituitary stalk enlargement. Clin Endocrinol(Oxf) 27 : 25-32, 1987 https://doi.org/10.1111/j.1365-2265.1987.tb00835.x
  10. Rhoton AL Jr : The sellar region. Neurosurgery 51 : S335-S374, 2002
  11. Seidel FG, Towbin R, Kaufman RA : Normal pituitary stalk size in children : CT study. AJR Am J Roentgenol 145 : 1297-1302, 1985 https://doi.org/10.2214/ajr.145.6.1297
  12. Simmons GE, Suchnicki JE, Rak KM, Damiano TR : MR imaging of the pituitary stalk : size, shape and enhancement pattern. Am J Roentgenol 159 : 375-377, 1992 https://doi.org/10.2214/ajr.159.2.1632360
  13. Simpkins JW, Estes KS : Role of monoaminergic neurons in the agerelated alterations in anterior pituitary secretion in Nemeroff CB, Duun AJ (eds) : Peptides, Hormones and Behaviors. New York : Spectrum Press, 1984, pp823-863
  14. Tsunoda A, Okuda O, Sato K : MR height of the pituitary gland as a function of age and sex : especially physiological hypertrophy in adolescence and in climacterium. AJNR Am J Neuroradiol 18 : 551-554, 1997
  15. Yasuda A, Campero A, Martins C, Rhoton AL, Ribas GC : The medial wall of the cavernous sinus : microsurgical anatomy. Neurosurgery 55 : 179-189; discussion 189-190, 2004 https://doi.org/10.1227/01.NEU.0000126953.59406.77
  16. Yokoyama S, Hirano H, Moroki K, Goto M, Imamura S, Kuratsu Jl : Are nonfunctioning pituitary adenomas extending into the cavernous sinus aggressive and/or invasive? Neurosurgery 49 : 857-862; discussion 862-863, 2001

피인용 문헌

  1. New Landmark for the Endoscopic Endonasal Transsphenoidal Approach of Pituitary Surgery vol.53, pp.4, 2010, https://doi.org/10.3340/jkns.2013.53.4.218
  2. Normal dimensions of the posterior pituitary bright spot on magnetic resonance imaging : Clinical article vol.120, pp.2, 2010, https://doi.org/10.3171/2013.11.jns131320
  3. The diaphragma sellae, diaphragm opening, and subdiaphragmatic cistern: an anatomical study using magnetic resonance imaging vol.41, pp.5, 2010, https://doi.org/10.1007/s00276-019-02184-0