MORPHOLOGICAL AND MRI-BASED ASSESSMENT OF GROWTH PATTERNS IN PITUITARY MACROADENOMAS WITH VARYING HORMONAL ACTIVITY

Аннотация

Abstract. Pituitary macroadenomas represent a heterogeneous group of benign intracranial neoplasms characterized by variable hormonal activity, growth dynamics, and anatomical invasion patterns. The objective of the present study was to perform a comparative MRI-based analysis of morphometric  parameters,  tumor  volume,  and  directional  growth  characteristics  of  pituitary macroadenomas depending on hormonal activity. A total of 305 patients with untreated pituitary macroadenomas  were  analyzed,  including  non-functioning  adenomas,  prolactinomas,  and somatotropinomas.  High-resolution  contrast-enhanced  magnetic  resonance  imaging  was  used  to evaluate tumor dimensions and extrasellar extension patterns. Volumetric assessment demonstrated statistically significant differences between tumor subtypes, with non-functioning adenomas exhibiting the largest median volumes, whereas somatotropinomas showed comparatively smaller dimensions but increased invasive infrasellar growth. Suprasellar extension predominated among non-functioning adenomas and prolactinomas, frequently associated with optic chiasm compression. Multidirectional extrasellar expansion was observed in the majority of patients, reflecting biomechanical and biological heterogeneity of adenohypophyseal tumors. The obtained results indicate that hormonal activity significantly  influences  tumor  growth  trajectory  and  anatomical  dissemination.  MRI-based morphometric evaluation may therefore serve as an important diagnostic and prognostic tool in preoperative planning and individualized management of patients with pituitary macroadenomas.