Magnetic resonance imaging finding of empty sella in obesity related idiopathic intracranial hypertension is associated with enlarged sella turcica.
Magnetic resonance imaging finding of empty sella in obesity related idiopathic intracranial hypertension is associated with enlarged sella turcica.
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DOI：
10.1007/s00234-013-1207-0
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发表时间：
2013-08
期刊：
影响因子：
2.8
通讯作者：
Alperin, Noam
中科院分区：
文献类型：
--
作者：
Ranganathan, Sudarshan;Lee, Sang H.;Checkver, Adam;Sklar, Evelyn;Lam, Byron L.;Danton, Gary H.;Alperin, Noam
MRI 中的空蝶鞍是与特发性颅内高压 (IIH) 相关的重要发现。本研究评估了鞍和垂体的几种形态学测量的敏感性和再现性，以确定最能区分 IIH 与对照的测量。此外，该研究还评估了治疗后腺体受压的逆转情况。从 10 名新诊断的 IIH 患者和 11 名匹配的健康对照中获得了各向同性分辨率为 1 mm 的矢状 3D-T1W 序列。腰椎穿刺和乙酰唑胺治疗 1 周后，对 8 名患者进行了随访 MRI 扫描。获得腺体和蝶鞍的绝对和标准化高度以及横截面积的一维和二维测量值，以确定最能区分 IIH 患者和对照的测量值。基于总体面积的测量比长度具有更高的灵敏度，蝶鞍面积的 p<0.0001，而标准化腺体高度的 p=0.004。两个队列的腺体横截面积相似 (p=0.557)，而 IIH 组的鞍区面积显着更大，分别为 200±24 和 124±25 mm2，敏感性和特异性最高，分别为 100% 和 90.9%。绝对腺体面积是评估治疗后变化最敏感的指标，具有 100% 的敏感性和 50% 的特异性。治疗后平均腺体面积增加了 18% (p=0.016)。然而，根据标准化腺体面积阈值 0.41，所有 8 名患者仍处于空蝶鞍范围内。 IIH 患者的鞍区面积较大，并且表现出区分 IIH 与对照受试者的最高敏感性，而绝对腺体面积对于检测治疗后变化更敏感。
Empty sella in MRI is an important finding associated with idiopathic intracranial hypertension (IIH). This study assesses the sensitivity and reproducibility of several morphological measures of the sella and pituitary gland to indentify the measure that best differentiates IIH from controls. Additionally, the study assesses reversal in gland compression following treatment. Sagittal 3D-T1W sequence with 1 mm isotropic resolution was obtained from ten newly diagnosed IIH patients and 11 matched healthy controls. Follow-up MRI scans were obtained from eight patients at 1-week postlumbar puncture and acetazolamide treatment. 1D and 2D measures of absolute and normalized heights and crosssectional areas of the gland and sella were obtained to identify the measure that best differentiates IIH patients and controls. Overall area-based measurements had higher sensitivity than length with p<0.0001 for sella area compared with p=0.004 for normalized gland height. The gland crosssectional areas were similar in both cohorts (p=0.557), while the sella area was significantly larger in IIH, 200±24 versus 124±25 mm2, with the highest sensitivity and specificity, 100 % and 90.9 %, respectively. Absolute gland area was the most sensitive measure for assessing post treatment changes, with 100 % sensitivity and 50 % specificity. Average posttreatment gland area was 18 % larger (p=0.016). Yet, all eight patients remained within the empty sella range based on a normalized gland area threshold of 0.41. Sellar area is larger in IIH, and it demonstrated highest sensitivity for differentiating IIH from control subjects, while absolute gland area was more sensitive for detecting post treatment changes.
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