{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T02:30:32Z","timestamp":1793154632394,"version":"4.5.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Cushing\u2019s disease is caused by adrenocorticotrophic hormone (ACTH)\u2013secreting pituitary adenomas, which are often difficult to identify on standard 1.5-T or 3-T MRI, including dynamic contrast imaging. Inferior petrosal and cavernous sinus sampling remains the gold standard for MRI-negative Cushing\u2019s disease.<\/jats:p><jats:p>The authors report on a 27-year-old woman with Cushing\u2019s disease in whom the results of standard 1.5-T and 3-T MRI, including 1.5-T dynamic contrast imaging, were negative. Inferior petrosal sinus sampling showed a high central-to-peripheral ACTH ratio (148:1) as well as a right-to-left ACTH gradient (19:1), suggesting a right-sided pituitary microadenoma. The patient underwent 7-T MRI, which showed evidence of a right-sided pituitary lesion with focal hypoenhancement not visualized on 1.5-T or 3-T MRI. The patient underwent an endoscopic endonasal transsphenoidal operation, with resection of a right-sided pituitary mass. Postoperatively, she developed clinical symptoms suggestive of adrenal insufficiency and a nadir cortisol level of 1.6 \u03bcg\/dl on postoperative day 3, and hydrocortisone therapy was initiated. Permanent histopathology specimens showed Crooke\u2019s hyaline change and ACTH-positive cells suggestive of an adenoma.<\/jats:p><jats:p>MRI at 7 T may be beneficial in identifying pituitary microadenoma location in cases of standard 1.5-T and 3-T MRI-negative Cushing\u2019s disease. In the future, 7-T MRI may preempt inferior petrosal sinus sampling and help in cases of standard and dynamic contrast 1.5-T and 3-T MRI-negative Cushing\u2019s disease.<\/jats:p>","DOI":"10.3171\/2017.9.jns171969","type":"journal-article","created":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T13:59:24Z","timestamp":1521813564000},"page":"347-351","source":"Crossref","is-referenced-by-count":16,"title":["Value of pituitary gland MRI at 7 T in Cushing\u2019s disease and relationship to inferior petrosal sinus sampling: case report"],"prefix":"10.3171","volume":"130","author":[{"given":"Meng","family":"Law","sequence":"first","affiliation":[{"name":"Departments of Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Wang","sequence":"additional","affiliation":[{"name":"Stevens Institute of Neuroimaging and Informatics, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Shang J.","family":"Liu","sequence":"additional","affiliation":[{"name":"Departments of Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Shiroishi","sequence":"additional","affiliation":[{"name":"Departments of Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Mack","sequence":"additional","affiliation":[{"name":"Neurosurgery, Keck School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Weiss","sequence":"additional","affiliation":[{"name":"Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny J. 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