{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:43:50Z","timestamp":1790181830508,"version":"4.1.0"},"reference-count":36,"publisher":"Bioscientifica","issue":"9","license":[{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["erc.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6,18]]},"abstract":"<jats:p>\n                    Cushing\u2019s disease is a rare condition that occurs due to an adrenocorticotrophin-producing corticotrophinoma arising from the pituitary gland. The consequent hypercortisolaemia results in multisystem morbidity and mortality. This study aims to report incidence, clinicopathological characteristics, remission outcomes and mortality in a regional pituitary neurosurgical cohort of patients diagnosed with Cushing\u2019s disease in Northern Ireland (NI) from 2000 to 2019. Clinical, biochemical and radiological data from a cohort of patients operated for Cushing\u2019s disease were retrospectively collected and analysed. Fifty-three patients were identified, resulting in an estimated annual incidence of Cushing\u2019s disease of 1.39\u20131.57 per million population per year. Females accounted for 72% (38\/53) of the cohort. The majority (74%, 39\/53) of corticotrophinomas were microadenomas and in 44% (17\/39) of these no tumour was identified on preoperative magnetic resonance imaging. Histopathological characterisation was similarly difficult, with no tumour being identified in the histopathological specimen in 40% (21\/53) of cases. Immediate postoperative remission rates were 53% and 66% when considering serum morning cortisol cut-offs of \u2264 50 nmol\/L (1.8 \u00b5g\/dL) and \u2264 138 nmol\/L (5 \u00b5g\/dL), respectively, in the week following pituitary surgery. Approximately 70% (37\/53) of patients achieved longer-term remission with a single pituitary surgery. Three patients had recurrent disease. Patients with Cushing\u2019s disease had a significantly higher mortality rate compared to the NI general population (standardised mortality ratio 8.10, 95% CI 3.3\u201316.7,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001). Annual incidence of Cushing\u2019s disease in NI is consistent with other Northern European cohorts. Functioning corticotrophinomas are a clinically, radiologically and histopathologically elusive disease with increased mortality compared to the general population.\n                  <\/jats:p>","DOI":"10.1530\/erc-24-0028","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T12:27:40Z","timestamp":1718713660000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":10,"title":["Insights on epidemiology, morbidity and mortality of Cushing\u2019s disease in Northern Ireland"],"prefix":"10.1530","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5491-6730","authenticated-orcid":true,"given":"Paul Benjamin","family":"Loughrey","sequence":"first","affiliation":[{"name":"Patrick G Johnston Centre for Cancer Research, Queen\u2019s University Belfast, Belfast, UK"},{"name":"Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Herron","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Cooke","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Weir","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayna Elizabeth","family":"Smyth","sequence":"additional","affiliation":[{"name":"Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen R","family":"Mullan","sequence":"additional","affiliation":[{"name":"Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle G","family":"Healy","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Evanson","sequence":"additional","affiliation":[{"name":"Department of Radiology, Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie G","family":"Craig","sequence":"additional","affiliation":[{"name":"Patrick G Johnston Centre for Cancer Research, Queen\u2019s University Belfast, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline A","family":"James","sequence":"additional","affiliation":[{"name":"Patrick G Johnston Centre for Cancer Research, Queen\u2019s University Belfast, Belfast, UK"},{"name":"Department of Cellular Pathology, Belfast Health and Social Care Trust, Belfast, UK"},{"name":"Northern Ireland Biobank, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4101-9432","authenticated-orcid":true,"given":"M\u00e1rta","family":"Korbonits","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J","family":"Hunter","sequence":"additional","affiliation":[{"name":"Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"European Journal of Endocrinology","first-page":"655","article-title":"The epidemiology of pituitary adenomas in Iceland, 1955\u20132012: a nationwide population-based study","volume":"173","author":"Agustsson","year":"2015","unstructured":"Agustsson TTBaldvinsdottir TJonasson JGOlafsdottir ESteinthorsdottir VSigurdsson GThorsson AVCarroll PVKorbonits M & Benediktsson R2015The epidemiology of pituitary adenomas in Iceland, 1955\u20132012: a nationwide population-based study. European Journal of Endocrinology173655\u2013664. (https:\/\/doi.org\/10.1530\/EJE-15-0189)"},{"key":"bib2","series-title":"European Journal of Endocrinology","first-page":"639","article-title":"Long-term remission and recurrence rates in Cushing\u2019s disease: predictive factors in a single-centre study","volume":"168","author":"Alexandraki","year":"2013","unstructured":"Alexandraki KIKaltsas GAIsidori AMStorr HLAfshar FSabin IAkker SAChew SLDrake WMMonson JP, et al.2013Long-term remission and recurrence rates in Cushing\u2019s disease: predictive factors in a single-centre study. European Journal of Endocrinology168639\u2013648. (https:\/\/doi.org\/10.1530\/EJE-12-0921)"},{"key":"bib3","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"2179","article-title":"Normalized early postoperative cortisol and ACTH values predict nonremission after surgery for Cushing disease","volume":"102","author":"Asuzu","year":"2017","unstructured":"Asuzu DChatain GPHayes CBenzo SMcGlotten RKeil MBeri ASharma STNieman LLodish M, et al.2017Normalized early postoperative cortisol and ACTH values predict nonremission after surgery for Cushing disease. Journal of Clinical Endocrinology and Metabolism1022179\u20132187. (https:\/\/doi.org\/10.1210\/jc.2016-3908)"},{"key":"bib4","series-title":"Clinical Endocrinology","first-page":"549","article-title":"Long-term remission rates after pituitary surgery for Cushing\u2019s disease: the need for long-term surveillance","volume":"63","author":"Atkinson","year":"2005","unstructured":"Atkinson ABKennedy AWiggam MIMcCance DR & Sheridan B2005Long-term remission rates after pituitary surgery for Cushing\u2019s disease: the need for long-term surveillance. Clinical Endocrinology63549\u2013559. (https:\/\/doi.org\/10.1111\/j.1365-2265.2005.02380.x)"},{"key":"bib5","series-title":"Clinical Endocrinology","first-page":"436","article-title":"Mortality and morbidity in Cushing\u2019s syndrome in New Zealand","volume":"75","author":"Bolland","year":"2011","unstructured":"Bolland MJHoldaway IMBerkeley JELim SDransfield WJConaglen JVCroxson MSGamble GDHunt PJ & Toomath RJ2011Mortality and morbidity in Cushing\u2019s syndrome in New Zealand. Clinical Endocrinology75436\u2013442. (https:\/\/doi.org\/10.1111\/j.1365-2265.2011.04124.x)"},{"key":"bib6","series-title":"BMC Endocrine Disorders","first-page":"36","article-title":"Outcomes of endoscopic transsphenoidal surgery for Cushing\u2019s disease","volume":"21","author":"Brady","year":"2021","unstructured":"Brady ZGarrahy ACarthy CO\u2019Reilly MWThompson CJSherlock MAgha A & Javadpour M2021Outcomes of endoscopic transsphenoidal surgery for Cushing\u2019s disease. BMC Endocrine Disorders2136. (https:\/\/doi.org\/10.1186\/s12902-021-00679-9)"},{"key":"bib7","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"3287","article-title":"Postoperative serum cortisol and Cushing disease recurrence in patients with corticotroph adenomas","volume":"108","author":"Catalino","year":"2023","unstructured":"Catalino MPMoore DTIronside NMunoz ARColey JJonas RKearns KMin LVance MLJane JAJr, et al.2023Postoperative serum cortisol and Cushing disease recurrence in patients with corticotroph adenomas. Journal of Clinical Endocrinology and Metabolism1083287\u20133294. 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(https:\/\/doi.org\/10.1111\/nyas.14205)"},{"key":"bib9","series-title":"Lancet Diabetes and Endocrinology","first-page":"847","article-title":"Consensus on diagnosis and management of Cushing\u2019s disease: a guideline update","volume":"9","author":"Fleseriu","year":"2021","unstructured":"Fleseriu MAuchus RBancos IBen-Shlomo ABertherat JBiermasz NRBoguszewski CLBronstein MDBuchfelder MCarmichael JD, et al.2021Consensus on diagnosis and management of Cushing\u2019s disease: a guideline update. Lancet Diabetes and Endocrinology9847\u2013875. 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(https:\/\/doi.org\/10.1210\/clinem\/dgz200)"},{"key":"bib11","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"1194","article-title":"Outcome of Cushing\u2019s disease following transsphenoidal surgery in a single center over 20 years","volume":"97","author":"Hassan-Smith","year":"2012","unstructured":"Hassan-Smith ZKSherlock MReulen RCArlt WAyuk JToogood AACooper MSJohnson AP & Stewart PM2012Outcome of Cushing\u2019s disease following transsphenoidal surgery in a single center over 20 years. Journal of Clinical Endocrinology and Metabolism971194\u20131201. (https:\/\/doi.org\/10.1210\/jc.2011-2957)"},{"key":"bib12","series-title":"European Journal of Endocrinology","first-page":"255","article-title":"Earlier post-operative hypocortisolemia may predict durable remission from Cushing\u2019s disease","volume":"178","author":"Ironside","year":"2018","unstructured":"Ironside NChatain GAsuzu DBenzo SLodish MSharma SNieman LStratakis CALonser RR & Chittiboina P2018Earlier post-operative hypocortisolemia may predict durable remission from Cushing\u2019s disease. European Journal of Endocrinology178255\u2013263. (https:\/\/doi.org\/10.1530\/EJE-17-0873)"},{"key":"bib13","series-title":"European Journal of Endocrinology","first-page":"75","article-title":"High prevalence of venous thrombotic events in Cushing\u2019s syndrome: data from ERCUSYN and details in relation to surgery","volume":"190","author":"Isand","year":"2024","unstructured":"Isand KFeelders RBrue TToth MDeutschbein TReincke MKrsek MSantos ADemtroder FChabre O, et al.2024High prevalence of venous thrombotic events in Cushing\u2019s syndrome: data from ERCUSYN and details in relation to surgery. European Journal of Endocrinology19075\u201385. (https:\/\/doi.org\/10.1093\/ejendo\/lvad176)"},{"key":"bib14","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"2377","article-title":"The effect of endogenous Cushing syndrome on all-cause and cause-specific mortality","volume":"107","author":"Limumpornpetch","year":"2022","unstructured":"Limumpornpetch PMorgan AWTiganescu ABaxter PDNyawira Nyaga VPujades-Rodriguez M & Stewart PM2022The effect of endogenous Cushing syndrome on all-cause and cause-specific mortality. Journal of Clinical Endocrinology and Metabolism1072377\u20132388. 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(https:\/\/doi.org\/10.1210\/jcem.86.1.7093)"},{"key":"bib16","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"2057","article-title":"The postoperative basal cortisol and CRH tests for prediction of long-term remission from Cushing\u2019s disease after transsphenoidal surgery","volume":"96","author":"Lindsay","year":"2011","unstructured":"Lindsay JROldfield EHStratakis CA & Nieman LK2011The postoperative basal cortisol and CRH tests for prediction of long-term remission from Cushing\u2019s disease after transsphenoidal surgery. Journal of Clinical Endocrinology and Metabolism962057\u20132064. (https:\/\/doi.org\/10.1210\/jc.2011-0456)"},{"key":"bib17","series-title":"Cancer Genetics","first-page":"36","article-title":"Invasive ACTH-producing pituitary gland neoplasm secondary to MSH2 mutation","volume":"256\u2013257","author":"Loughrey","year":"2021","unstructured":"Loughrey PBBaker GHerron BCooke SIacovazzo DLindsay JR & Korbonits M2021Invasive ACTH-producing pituitary gland neoplasm secondary to MSH2 mutation. Cancer Genetics256\u201325736\u201339. (https:\/\/doi.org\/10.1016\/j.cancergen.2021.03.008)"},{"key":"bib18","series-title":"Journal of Neurosurgery","first-page":"803","article-title":"Invasion of the cavernous sinus space in pituitary adenomas: endoscopic verification and its correlation with an MRI-based classification","volume":"122","author":"Micko","year":"2015","unstructured":"Micko ASGWohrer AWolfsberger S & Knosp E2015Invasion of the cavernous sinus space in pituitary adenomas: endoscopic verification and its correlation with an MRI-based classification. Journal of Neurosurgery122803\u2013811. (https:\/\/doi.org\/10.3171\/2014.12.JNS141083)"},{"key":"bib19","series-title":"Pituitary","first-page":"551","article-title":"Complications and mortality of Cushing\u2019s disease: report on data collected over a 20-year period at a referral centre","volume":"26","author":"Mondin","year":"2023","unstructured":"Mondin ACeccato FVoltan GMazzeo PManara RDenaro LScaroni C & Barbot M2023Complications and mortality of Cushing\u2019s disease: report on data collected over a 20-year period at a referral centre. Pituitary26551\u2013560. (https:\/\/doi.org\/10.1007\/s11102-023-01343-2)"},{"key":"bib37","year":"2001","unstructured":"NISRA 20012001 census results key statistics report: tables. Belfast, UK: Northern Ireland Statistics and Research Agency. (available at: https:\/\/www.nisra.gov.uk\/sites\/nisra.gov.uk\/files\/publications\/2001-census-results-key-statistics-report-tables.pdf)"},{"key":"bib38","year":"2021","unstructured":"NISRA 20212021 census. Belfast, UK: Northern Ireland Statistics and Research Agency. (available at: https:\/\/www.nisra.gov.uk\/statistics\/census\/2021-census)"},{"key":"bib22","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"2807","article-title":"Treatment of Cushing\u2019s Syndrome: an endocrine society clinical practice guideline","volume":"100","author":"Nieman","year":"2015","unstructured":"Nieman LKBiller BMKFindling JWMurad MHNewell-Price JSavage MOTabarin A & Endocrine Society2015Treatment of Cushing\u2019s Syndrome: an endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism1002807\u20132831. (https:\/\/doi.org\/10.1210\/jc.2015-1818)"},{"key":"bib23","series-title":"American Journal of Medicine","first-page":"597","article-title":"The natural history of Cushing\u2019s syndrome","volume":"13","author":"Plotz","year":"1952","unstructured":"Plotz CMKnowlton AI & Ragan C1952The natural history of Cushing\u2019s syndrome. American Journal of Medicine13597\u2013614. (https:\/\/doi.org\/10.1016\/0002-9343(5290027-2)"},{"key":"bib24","series-title":"Pituitary","first-page":"179","article-title":"The incidence of Cushing\u2019s disease: a nationwide Swedish study","volume":"22","author":"Ragnarsson","year":"2019","unstructured":"Ragnarsson OOlsson DSChantzichristos DPapakokkinou EDahlqvist PSegerstedt EOlsson TPetersson MBerinder KBensing S, et al.2019The incidence of Cushing\u2019s disease: a nationwide Swedish study. Pituitary22179\u2013186. (https:\/\/doi.org\/10.1007\/s11102-019-00951-1)"},{"key":"bib25","series-title":"Journal of Neurosurgery","first-page":"37","article-title":"Early repeat surgery for persistent Cushing\u2019s disease","volume":"80","author":"Ram","year":"1994","unstructured":"Ram ZNieman LKCutler GBJrChrousos GPDoppman JL & Oldfield EH1994Early repeat surgery for persistent Cushing\u2019s disease. Journal of Neurosurgery8037\u201345. (https:\/\/doi.org\/10.3171\/jns.1994.80.1.0037)"},{"key":"bib26","series-title":"European Journal of Endocrinology","first-page":"G1","article-title":"European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas","volume":"178","author":"Raverot","year":"2018","unstructured":"Raverot GBurman PMcCormack AHeaney APetersenn SPopovic VTrouillas JDekkers OM & European Society of Endocrinology2018European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas. European Journal of Endocrinology178G1\u2013G24. (https:\/\/doi.org\/10.1530\/EJE-17-0796)"},{"key":"bib27","series-title":"European Journal of Endocrinology","first-page":"P1","article-title":"Corticotroph tumor progression after bilateral adrenalectomy (Nelson\u2019s syndrome): systematic review and expert consensus recommendations","volume":"184","author":"Reincke","year":"2021","unstructured":"Reincke MAlbani AAssie GBancos IBrue TBuchfelder MChabre OCeccato FDaniele ADetomas M, et al.2021Corticotroph tumor progression after bilateral adrenalectomy (Nelson\u2019s syndrome): systematic review and expert consensus recommendations. European Journal of Endocrinology184P1\u2013P16."},{"key":"bib28","series-title":"Acta Neurochirurgica","first-page":"119","article-title":"Long-term outcome of trans-sphenoidal surgery for Cushing\u2019s disease in Indian patients","volume":"161","author":"Saini","year":"2019","unstructured":"Saini SKanwar JGupta SBehari SBhatia E & Yadav S2019Long-term outcome of trans-sphenoidal surgery for Cushing\u2019s disease in Indian patients. Acta Neurochirurgica161119\u2013127. (https:\/\/doi.org\/10.1007\/s00701-018-3736-0)"},{"key":"bib29","series-title":"Pituitary","first-page":"595","article-title":"Outcomes of pituitary surgery for Cushing\u2019s disease: a systematic review and meta-analysis","volume":"23","author":"Stroud","year":"2020","unstructured":"Stroud ADhaliwal PAlvarado RWinder MJJonker BPGrayson JWHamizan AHarvey RJ & McCormack A2020Outcomes of pituitary surgery for Cushing\u2019s disease: a systematic review and meta-analysis. Pituitary23595\u2013609. (https:\/\/doi.org\/10.1007\/s11102-020-01066-8)"},{"key":"bib30","series-title":"Journal of Neuroendocrinology","first-page":"e13114","article-title":"Clinical presentation and etiology of Cushing\u2019s syndrome: data from ERCUSYN","volume":"34","author":"Valassi","year":"2022","unstructured":"Valassi E2022Clinical presentation and etiology of Cushing\u2019s syndrome: data from ERCUSYN. Journal of Neuroendocrinology34e13114. (https:\/\/doi.org\/10.1111\/jne.13114)"},{"key":"bib31","series-title":"European Journal of Endocrinology","first-page":"383","article-title":"The European Registry on Cushing\u2019s syndrome: 2-year experience. Baseline demographic and clinical characteristics","volume":"165","author":"Valassi","year":"2011","unstructured":"Valassi ESantos AYaneva MToth MStrasburger CJChanson PWass JAHChabre OPfeifer MFeelders RA, et al.2011The European Registry on Cushing\u2019s syndrome: 2-year experience. Baseline demographic and clinical characteristics. European Journal of Endocrinology165383\u2013392. (https:\/\/doi.org\/10.1530\/EJE-11-0272)"},{"key":"bib32","series-title":"European Journal of Endocrinology","first-page":"613","article-title":"Diagnostic tests for Cushing\u2019s syndrome differ from published guidelines: data from ERCUSYN","volume":"176","author":"Valassi","year":"2017","unstructured":"Valassi EFranz HBrue TFeelders RANetea-Maier RTsagarakis SWebb SMYaneva MReincke MDroste M, et al.2017Diagnostic tests for Cushing\u2019s syndrome differ from published guidelines: data from ERCUSYN. European Journal of Endocrinology176613\u2013624. 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(https:\/\/doi.org\/10.1530\/EJE-17-0997)"},{"key":"bib34","series-title":"Frontiers in Endocrinology","first-page":"805","article-title":"Hypercoagulability and risk of venous thromboembolic events in endogenous Cushing\u2019s syndrome: A systematic meta-analysis","volume":"9","author":"Wagner","year":"2018","unstructured":"Wagner JLanglois FLim DSTMcCartney S & Fleseriu M2018Hypercoagulability and risk of venous thromboembolic events in endogenous Cushing\u2019s syndrome: A systematic meta-analysis. Frontiers in Endocrinology9805. (https:\/\/doi.org\/10.3389\/fendo.2018.00805)"},{"key":"bib35","series-title":"Clinical Endocrinology","first-page":"263","article-title":"The incidence of endogenous Cushing\u2019s syndrome in the modern era","volume":"91","author":"Wengander","year":"2019","unstructured":"Wengander STrimpou PPapakokkinou E & Ragnarsson O2019The incidence of endogenous Cushing\u2019s syndrome in the modern era. Clinical Endocrinology91263\u2013270. (https:\/\/doi.org\/10.1111\/cen.14014)"},{"key":"bib36","series-title":"World Neurosurgery","first-page":"525","article-title":"Surgical management and outcomes in patients with Cushing disease with negative pituitary magnetic resonance imaging","volume":"77","author":"Yamada","year":"2012","unstructured":"Yamada SFukuhara NNishioka HTakeshita AInoshita NIto J & Takeuchi Y2012Surgical management and outcomes in patients with Cushing disease with negative pituitary magnetic resonance imaging. World Neurosurgery77525\u2013532. 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