Time-signal curves analysis of dynamic contrast-enhanced magnetic resonance imaging used in differential diagnosis of pituitary lesions.
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.

Figures

Fig 1 Time-signal curves analysis

Fig 2 pituitary microadenoma

Fig 3 Rathke’s cleft cyst



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
1378