ArticleAJNR. American journal of neuroradiology2011
Clival invasion on multi-detector CT in 390 pituitary macroadenomas: correlation with sex, subtype and rates of operative complication and recurrence.
Article in AJNR. American journal of neuroradiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 45 citations in OpenAlex.
- Pituitary neuroendocrine tumors: imaging features, clinical relevance, and a proposal for standardized MRI reporting.Neuroradiology · 2026Review
- Article
- Pituitary Neuroendocrine Tumors Extending Primarily Below the Sella and into the Clivus: A Distinct Growth Pattern with Specific Challenges.Current oncology (Toronto, Ont.) · 2026Article
- Risk factor identification and nomogram-based predictive model development for recurrence of pituitary adenomas following transsphenoidal surgery: a dual-center retrospective study.Frontiers in surgery · 2026Article
- Clival and paraclival pathologies: imaging features and differential diagnosis.Diagnostic and interventional radiology (Ankara, Turkey) · 2025Review
- Decision-Making in Clival Mass Lesions: Risk Factors for Malignant Disease and an Illustrative Case Example.Journal of neurological surgery reports · 2023Article
- Sphenoid sinus anatomical variants and pathologies: pictorial essay.Neuroradiology · 2023Article
- Clival and Paraclival Lesions: A Pictorial Review.The Indian journal of radiology & imaging · 2023Article
- Fluorescence guided surgery for pituitary adenomas.Journal of neuro-oncology · 2021Review
- Invasive Corridor of Clivus Extension in Pituitary Adenoma: Bony Anatomic Consideration, Surgical Outcome and Technical Nuances.Frontiers in oncology · 2021Article
- Review
- Preoperative embolization and immediate removal of a giant pituitary adenoma: a case report.BMC research notes · 2017Article
- Invagination of the Sphenoid Sinus Mucosa after Endoscopic Endonasal Transsphenoidal Approach and Its Significance.PloS one · 2016Article
- Advances in computed tomography evaluation of skull base diseases.International archives of otorhinolaryngology · 2014Review
- Evaluation of Clinical and Magnetic Resonance Imaging Profile of Pituitary Macroadenoma: A Prospective Study.Journal of natural science, biology, and medicineArticle
- The use of image-guidance during transsphenoidal pituitary surgery in the United States.American journal of rhinology & allergyArticle
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeClival invasion, a rare but potentially significant complication of pituitary adenoma, is difficult to detect on MR imaging. Because CT is widely used in adjunct guidance of pituitary surgery and it has recently been suggested that preoperative CT may add useful diagnostic information in addition to pituitary MR imaging, we performed the first large cross-sectional imaging study to define the image attributes, clinical correlates, and prognostic implications of clival invasion on CT for pituitary adenoma surgical guidance. MATERIALS AND
methodsPreoperative CT images from 390 patients with histopathologically diagnosed pituitary macroadenoma were reviewed retrospectively and classified by the presence and degree of clival invasion. Tumor volume, tumor subtype, patient sex, operative complication, and recurrence rates were compared between groups.
resultsAfter we corrected for multiple correlations, the most significant independent risk factor for clival invasion was female sex (OR=3.62, P=.014, multinomial logistic regression), followed by large tumor volume (OR=1.08, P<.001), and null-cell subtype (OR=5.47, P<.001). Larger tumor volume correlated with null-cell subtype (Mann-Whitney U test, P=.006), incidence of clival invasion (P<.001), and extent of clival invasion (P=.038). Clival invasion was associated with a significantly higher ratio of operative complications (15.63%, χ(2)=7.067, P=.008) and recurrence (57.14%, χ(2)=10.739, P=.001).
conclusionsCT detection of clival invasion by pituitary macroadenoma is significantly more common in women, in patients with large tumors, and in patients with null-cell tumors, and it is associated with a higher rate of operative complications and recurrences. Attention to the presence of clival invasion on preoperative CT and prospective investigation of its prognostic significance are indicated. Attention to this finding on pituitary guidance CT is warranted.
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