Evaluation of pituitary structures and lesions with turbo spin-echo diffusion-weighted imaging
Evaluation of pituitary structures and lesions with turbo spin-echo diffusion-weighted imaging
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DOI：
10.1016/j.jns.2019.07.008
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发表时间：
2019-10-15
影响因子：
4.4
通讯作者：
Hirai, Toshinori
中科院分区：
文献类型：
--
作者：
Khant, Zaw Aung;Azuma, Minako;Hirai, Toshinori
背景和目的：快速自旋回波弥散加权成像（TSE-DWI）尚未用于评价垂体病变。我们比较了有用的TSE-DWI和回波平面（EP）-DWI评估正常垂体结构和lessons.Materials和方法：我们的研究包括41例连续患者（27垂体腺瘤，8 Rathke的裂囊肿，4颅咽管瘤，1生殖细胞瘤，1垂体转移瘤）谁进行了常规的前和后对比磁共振成像（MRI）和TSE-和EP-DWI在3 T。两名观察员独立地对矢状面DWI和表观扩散系数（ADC）图上的正常垂体结构和病变进行定性评估。一名观察员记录了正常脑结构和垂体病变的ADC值。采用Kappa（kappa）统计、Wilcoxon秩和检验、组内相关系数、Bland-Altman检验、Pearson相关系数和独立样本t检验进行统计学分析。在DWI和ADC图上，TSE序列对垂体的显示、病灶与正常周围的空间关系以及整体图像质量均明显优于EP序列（p <0.01）。在正常脑结构中，TSE序列和EP序列的ADC值显著相关（r = 0.6979，p <0.05）。垂体腺瘤的TSE-ADC值明显低于颅咽管瘤（p <0.05）。结论：TSE-DWI对正常垂体结构和病变的评价优于EP-DWI。TSE-ADC值有助于鉴别垂体腺瘤和颅咽管瘤。
Background and purpose: Turbo spin-echo diffusion-weighted imaging (TSE-DWI) has not been used for evaluating pituitary lesions. We compared the usefulness of TSE-DWI and echo-planar (EP)-DWI for assessing normal pituitary structures and lesions.Materials and methods: Our study included 41 consecutive patients (27 pituitary adenomas, 8 Rathke's cleft cysts, 4 craniopharyngiomas, 1 germinoma, 1 pituitary metastasis) who underwent conventional pre- and post-contrast magnetic resonance imaging (MRI) and TSE- and EP-DWI at 3T. Two observers independently performed qualitative assessment of normal pituitary structures and lesions on sagittal DWI and apparent diffusion coefficient (ADC) maps. One observer recorded ADC values of normal brain structures and pituitary lesions. Kappa (kappa) statistics, Wilcoxon signed-rank test, intraclass correlation coefficient, Bland-Altman analysis, Pearson correlation coefficient and independent t-test were used for statistical analysis.Results: Interobserver agreement for qualitative evaluations was good to excellent (kappa = 0.65-1.0). On both DWI and ADC maps, visualization of the pituitary gland, of the spatial relationship between the lesion and its normal surroundings, and the whole image quality were significantly better on TSE- than EP sequences (p < .01). In normal brain structures, the ADC value on TSE- and EP-sequences was significantly correlated (r = 0.6979, p < .05). The TSE-ADC value was significantly lower for pituitary adenomas than craniopharyngiomas (p < .05).Conclusions: For the evaluation of normal pituitary structures and lesions, TSE-DWI is more useful than EP-DWI. The TSE-ADC value may help to differentiate between pituitary adenoma and craniopharyngioma.