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Intracranial internal carotid artery changes in acromegaly: a quantitative magnetic resonance angiography study

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Abstract

Purpose

Although cerebrovascular mortality is increased up to eightfold in acromegaly, intracranial internal carotid artery (ICA) changes have not been well investigated. This is a magnetic resonance angiography (MRA) quantitative cross-sectional study of ICA tortuosity, ectasia and intercarotid distance in acromegalic patients with subsequent analysis of concomitant clinical, laboratory and neuroimaging findings.

Methods

One hundred seventy six acromegalic patients (mean-age 55 ± 14 years, age range 21–88, 92 females) and 104 subjects with headache or transient neurological deficits underwent MRA with the same 1.5 T scanner. Clinical data, laboratory and pituitary adenoma imaging findings were recorded. Using a commercially available software, we measured the tortuosity index [(curved/linear ICA length from C3-midpoint to intracranial bifurcation) − 1], ICA ectasia index (intracavernous/petrous ICA diameter) and intercarotid distance at C3 and C4 levels.

Results

Mean ICA tortuosity and ectasia indices were increased in acromegalic patients compared with controls (1.06 ± 0.29 vs 0.93 ± 0.26, p < 0.001; 1.02 ± 0.10 vs 0.92 ± 0.09, p < 0.001). Mean intercarotid distance was reduced at C3 and increased at C4 in acromegalic patients (16.7 ± 3.4 vs 17.9 ± 2.5 mm, p < 0.001; 16.7 ± 4.6 vs 15.4 ± 4.1 mm, p < 0.05; t test). ICA tortuosity and ectasia correlated neither with laboratory findings nor with previous or current treatment. On multivariate analysis, C3 intercarotid distance was reduced in patients on dopamine agonist treatment (p < 0.01) and increased in patients with GH-deficit (p = 0.01), while C4 intercarotid distance was increased with macroadenoma (p = 0.01) and reduced in patients under dopamine agonist (p < 0.01) or somatostatin analogue (p < 0.05) treatment.

Conclusions

Intracranial ICA changes are common findings in acromegaly, and further studies focused on their possible clinical impact are needed.

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Conflict of interest

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Author information

Authors and Affiliations

  1. Neuroradiology, University of Salerno, Via S. Allende, 84081, Baronissi, Italy

    Renzo Manara & Francesco Di Salle

  2. IRCCS, S. Camillo, Venice, Italy

    Renzo Manara & Valentina Citton

  3. Neuroradiologic Unit, University Hospital of Padua, Padua, Italy

    Joseph Gabrieli & Giulia Bommarito

  4. DIMED, University of Padua, Padua, Italy

    Filippo Ceccato, Silvia Rizzati, Francesca Dassie, Carla Scaroni, Chiara Martini & Pietro Maffei

  5. Neurology, Department of Neuroscience, University of Padua, Padua, Italy

    Chiara Briani & Mario Ermani

  6. Neurosurgery, University Hospital of Padua, Padua, Italy

    Alessandro Della Puppa

  7. Neurosurgery, Department of Neuroscience, University of Padua, Padua, Italy

    Laura Milanese

Authors
  1. Renzo Manara
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  2. Joseph Gabrieli
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  3. Valentina Citton
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  8. Alessandro Della Puppa
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  9. Francesca Dassie
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  10. Laura Milanese
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  11. Francesco Di Salle
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  13. Carla Scaroni
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  14. Chiara Martini
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  15. Pietro Maffei
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Corresponding author

Correspondence to Renzo Manara.

Additional information

Renzo Manara and Joseph Gabrieli have equally contributed to the manuscript and should be considered first coauthors.

Chiara Martini and Pietro Maffei should be considered co-senior authors.

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Manara, R., Gabrieli, J., Citton, V. et al. Intracranial internal carotid artery changes in acromegaly: a quantitative magnetic resonance angiography study. Pituitary 17, 414–422 (2014). https://doi.org/10.1007/s11102-013-0516-y

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  • DOI: https://doi.org/10.1007/s11102-013-0516-y

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