The Diagnostic Value of Conventional MRI Combined With Diffusion-Weighted Imaging in Microprolactinomas

IF 3.5 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Magnetic Resonance Imaging Pub Date : 2024-07-12 DOI:10.1002/jmri.29531

Min-Yang Wang MM, Ying Yu MD, Yu Han MD, Yang Yang PhD, Wan Jiang MM, Jin Liu MS, Lin-Feng Yan MD, Guang-Bin Cui MD

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Abstract

Background

Turbo spin-echo (TSE) diffusion-weighted imaging (DWI) sequences may reduce susceptibility artifacts and image distortion in sellar region, allowing better visualization of small pituitary lesions, and may be used to assist in the diagnosis of pituitary microadenomas.

Purpose

To explore the application value of conventional MRI combined with DWI sequences in the diagnosis of microprolactinomas.

Study Type

Prospective.

Population

Thirty-four patients in microprolactinomas with high signal on T₂WI (HT₂-PRL) group (34 females, 34 ± 7 years), 26 patients in microprolactinomas with equal or low signal on T₂WI (ELT₂-PRL) group (21 females, 34 ± 7 years), 35 patients with hyperprolactinemia (33 females, 32 ± 8 years), and 30 normal controls (25 females, 31 ± 7 years).

Field Strength/Sequence

TSE sequence at 3 T.

Assessment

Pituitary morphological parameters (such as length and volume), dynamic contrast-enhanced parameters (such as time to peak) and the apparent diffusion coefficients (ADCs) were measured in each group.

Statistical Tests

ANOVA and Mann–Whitney U test were used to compare parameters among groups. Spearman's coefficient was used to evaluate the correlation between variables. ROC analysis was used to assess the performance of the parameters. A P-value <0.05 was considered statistically significant.

Results

The pituitary volume of patients in HT₂-PRL, ELT₂-PRL, and hyperprolactinemia group were 831.00 (747.60, 887.60), 923.63 ± 219.34, and 737.20 (606.40, 836.80) mm³. The pituitary maximum height in these three groups were 7.03 (6.43, 8.63), 8.03 ± 1.41, and 6.63 ± 1.28 mm, respectively. The lesion ADC value was significantly correlated with T₂ relative signal intensity (the ratio of signal intensity of microprolactinoma or anterior pituitary to left temporal cortex) (r = 0.821). Compared with patients with hyperprolactinemia, the diagnostic efficacy of T₂ relative signal intensity was higher in HT₂-PRL group, with an AUC of 0.954, whereas the ADC value was the highest in ELT₂-PRL group, with an AUC of 0.924.

Conclusion

DWI sequences can be used to assist in the diagnosis of pituitary microadenomas.

Evidence Level

Technical Efficacy

Stage 2

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传统磁共振成像结合扩散加权成像对微小泌乳素瘤的诊断价值。

背景：目的：探讨常规MRI结合DWI序列在垂体微腺瘤诊断中的应用价值：研究类型：前瞻性：T2WI高信号微泌乳素瘤（HT2-PRL）组34例患者（34名女性，34±7岁），T2WI等信号或低信号微泌乳素瘤（ELT2-PRL）组26例患者（21名女性，34±7岁），高催乳素血症患者35例（33名女性，32±8岁），正常对照组30例（25名女性，31±7岁）：场强/序列：3 T 的 TSE 序列：每组均测量垂体形态学参数（如长度和体积）、动态对比增强参数（如达到峰值的时间）和表观弥散系数（ADC）：方差分析和曼-惠特尼 U 检验用于比较组间参数。斯皮尔曼系数用于评估变量之间的相关性。ROC 分析用于评估参数的性能。A P值结果：HT2-PRL组、ELT2-PRL组和高泌乳素血症组患者的垂体体积分别为831.00（747.60，887.60）、923.63 ± 219.34和737.20（606.40，836.80）mm3。这三组的垂体最大高度分别为 7.03（6.43，8.63）、8.03 ± 1.41 和 6.63 ± 1.28 mm。病变 ADC 值与 T2 相对信号强度（微小泌乳素瘤或垂体前叶与左侧颞叶皮质信号强度之比）显著相关（r = 0.821）。与高泌乳素血症患者相比，T2相对信号强度在HT2-PRL组的诊断效力更高，AUC为0.954，而ADC值在ELT2-PRL组最高，AUC为0.924：结论：DWI 序列可用于垂体微腺瘤的辅助诊断。

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来源期刊

Journal of Magnetic Resonance Imaging 医学-核医学

CiteScore

9.70

自引率

6.80%

发文量

494

审稿时长

2 months

期刊介绍： The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.