Cushing's disease and negative MRI: a single-center series, systematic literature review, and meta-analysis - PubMed
3 hours ago
- #Cushing's Disease
- #MRI-negative
- #ACTH hyperplasia
- Cushing's Disease (CD) presents diagnostic and therapeutic challenges, especially with negative MRI findings for PitNET.
- A systematic review and meta-analysis of 35 studies showed a 70% surgical remission rate in MRI-negative CD, lower than MRI-positive cases (82%).
- ACTH hyperplasia was found in 19.6% of MRI-negative CD patients across studies and 45% in a single-center series.
- Endoscopic pituitary exploration is effective for histological data collection, with remission rates linked to histology findings.
- Surgical complications included CSF leak, transient diabetes insipidus, and need for thyroid axis therapy.
- 30% of MRI-negative CD patients do not achieve surgical remission, with ACTH hyperplasia potentially contributing to failure rates.