Pierallini Alberto, Caramia Francesca, Falcone Carlo, Tinelli Emanuele, Paonessa Amalia, Ciddio Alessia Bernardo, Fiorelli Marco, Bianco Federico, Natalizi Stefania, Ferrante Luigi, Bozzao Luigi
Neuroradiology Section and Neuroradiology Unit, Department of ENS and Neurology, University of Rome La Sapienza, Viale dell'Università 30, 00185 Rome, Italy.
Radiology. 2006 Apr;239(1):223-31. doi: 10.1148/radiol.2383042204. Epub 2006 Feb 1.
To prospectively evaluate use of diffusion-weighted (DW) magnetic resonance (MR) images and apparent diffusion coefficient (ADC) maps for determination of the consistency of macroadenomas.
The study protocol was approved by the institutional ethics committee, and informed consent was obtained from all patients. Twenty-two patients with pituitary macroadenoma (10 men, 12 women; mean age, 54 years +/- 17.09 [standard deviation]; range, 21-75 years) were examined. All patients underwent MR examination, which included T1-weighted spin-echo and T2-weighted turbo spin-echo DW imaging with ADC mapping and contrast material-enhanced T1-weighted spin-echo imaging. Regions of interest (ROIs) were drawn in the macroadenomas and in normal white matter on DW images, ADC maps, and conventional MR images. Consistency of macroadenomas was evaluated at surgery and was classified as soft, intermediate, or hard. Histologic examination was performed on surgical specimens of macroadenomas. Mean ADC values, signal intensity (SI) ratios of tumor to white matter within ROIs on conventional and DW MR images, and degree of enhancement were compared with tumor consistency and with percentage of collagen content at histologic examination by using analysis of variance for linear trend.
The mean value of ADC in the soft group was (0.663 +/- 0.109) x 10(-3) mm(2)/sec; in the intermediate group, (0.842 +/- 0.081) x 10(-3) mm(2)/sec; and in the hard group, (1.363 +/- 0.259) x 10(-3) mm(2)/sec. Statistical analysis revealed a significant correlation between tumor consistency and ADC values, DW image SI ratios, T2-weighted image SI ratios, and percentage of collagen content (P < .001, analysis of variance). No other statistically significant correlations were found.
Findings in this study suggest that DW MR images with ADC maps can provide information about the consistency of macroadenomas.
前瞻性评估扩散加权（DW）磁共振（MR）图像及表观扩散系数（ADC）图在判定大腺瘤质地一致性方面的应用价值。
本研究方案获机构伦理委员会批准，所有患者均签署知情同意书。对22例垂体大腺瘤患者（男性10例，女性12例；平均年龄54岁±17.09[标准差]；年龄范围21 - 75岁）进行检查。所有患者均接受MR检查，包括T1加权自旋回波序列、T2加权快速自旋回波序列的DW成像及ADC图，以及对比剂增强T1加权自旋回波成像。在DW图像、ADC图及常规MR图像上，于大腺瘤及正常白质区域绘制感兴趣区（ROI）。手术中评估大腺瘤的质地一致性，并分为软、中等及硬三类。对大腺瘤手术标本进行组织学检查。采用线性趋势方差分析，比较平均ADC值、常规及DW MR图像上ROI内肿瘤与白质的信号强度（SI）比值、强化程度与肿瘤质地一致性及组织学检查时胶原含量百分比之间的关系。
软质地组ADC平均值为（0.663±0.109）×10⁻³mm²/sec；中等质地组为（0.842±0.081）×10⁻³mm²/sec；硬质地组为（1.363±0.259）×10⁻³mm²/sec。统计学分析显示，肿瘤质地一致性与ADC值、DW图像SI比值、T2加权图像SI比值及胶原含量百分比之间存在显著相关性（P <.001，方差分析）。未发现其他具有统计学意义的相关性。
本研究结果提示，结合ADC图的DW MR图像能够提供有关大腺瘤质地一致性的信息。
