shiyun tian1, Weiwei Wang1, and yanwei miao1
1Radiology Department, the First Affiliated Hospital of Dalian Medical University, Dalian, China, People's Republic of
Synopsis
Pituitary
microadenomas are commonly visualized as well-defined lesions that enhance less
than the normal pituitary gland, but it is not clear about the enhancement
pattern of microadenomas. Our work is to evaluate the TIC type and the five
parameters extracted from time-signal curves of DCE-MRI in the normal pituitary
gland, microadenoma and the Rathke’s cleft cyst.purpose
In our daily work,
pituitary microadenomas are commonly visualized as well-defined lesions that
enhance less than the normal pituitary gland, but it is not clear about the enhancement
pattern of microadenomas. DCE-MRI is an imaging technique which can be used to
investigate the physiology of tissue microvasculature and therefore serves as a
more objective method of pituitary lesions assessment. The aim of our study is
to evaluate the usefulness of DCE-MRI , including time-signal curves
analysis in the differentiation of normal pituitary gland
and pituitary lesions, including microadenoma and the Rathke’s cleft cyst(RCC).
Methods
Fifty-three patients
(38 women and 15 men; mean age=41.6±16.5) with nonfunctioning pituitary microadenomas,
seven patients with RCC(2women and 5men; mean age=45.7±16.5) and twenty-seven normal
controls (15 women and 12men; mean age=40.2±10.5) were enrolled in the study.
Four patients with microadenomas and seven with RCC were revealed by
histopathological examinations obtained after resection. Forty-nine cases were
confirmed by diagnostic therapy and follow up. Imaging was performed on a 3.0T
GE scanner using an 8-channel head coil. Conventional sequences were included:
coronal and sagittal T1 FSE, coronal and sagittal T2 FSE, dynamic contrast
enhanced MRI for pituitary gland containing seven-multiple phase (
3.5second/phase ), and post-contrast T1-weighted images in coronal. The
time-signal curves were extracted from the DCE-MRI. Post-processing of data and
measurements were performed using the commercial GE Healthcare workstation
(ADW4.4). Five parameters including TIC type, maximum signal (SImax),
the peak time (Tmax), early enhancement ratio in the second-phase (7second),
the third-phase (10.5 second) and enhancement ratio were obtianed. These
parameters from normal pituitary, microadenomas and RCC were compared using
Student-Newrnan-Keuls’s q-test and the p<0.05 was deemed as a significant
level.
Results
Normal pituitary
gland shows a raise-up type, nonfunctioning microadenoma
displays a slowly rising type, and the Rathke’s cleft cyst exhibits a platform
type. Of normal pituitary gland , microadenoma and the Rathke’s cleft cyst, the
maximum signal is 2067±675, 1629±492, 887±345(p value=0.00), and the peak time
is 17±6, 17±6, 7.5±6.5(p value=0.001); early enhancement ratio in the second-phase is
0.8±0.6, 1.1±0.9, 0.5±0.4(p value>0.05), early enhancement ratio in the
third-phase is 1.4 ±0.8, 1.3±0.9, 0.5±0.3(p value=0.046); the enhance rate is
1.9 ±1.0, 1.7±0.9, 0.7±0.4(p value=0.009). The p<0.05 was set as a
significant level. The maximum signal (SImax), the peak time (Tmax),
early enhancement ratio in the third-phase and enhancement ratio showed significantly difference, respectively.
Conclusion
DCE-MRI with
time-signal curves analysis in the differential diagnosis of pituitary lesions
is feasible. It can display the reinforcement mode of the normal pituitary, microadenoma
and the RCC instead of only relying on the vision. DCE-MRI is useful for
differential diagnosis of the normal pituitary gland and the pituitary lesions,
including
microadenoma and the Rathke’s cleft cyst.
Acknowledgements
No acknowledgement found.References
No reference found.