Stadlbauer Andreas, Buchfelder Michael, Nimsky Christopher, Saeger Wolfgang, Salomonowitz Erich, Pinker Katja, Richter Gregor, Akutsu Hiroyoshi, Ganslandt Oliver
Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany.
J Neurosurg. 2008 Aug;109(2):306-12. doi: 10.3171/JNS/2008/109/8/0306.
The aim of this study was to correlate proton MR (1H-MR) spectroscopy data with histopathological and surgical findings of proliferation and hemorrhage in pituitary macroadenomas.
Quantitative 1H-MR spectroscopy was performed on a 1.5-T unit in 37 patients with pituitary macroadenomas. A point-resolved spectroscopy sequence (TR 2000 msec, TE 135 msec) with 128 averages and chemical shift selective pulses for water suppression was used. Voxel dimensions were adapted to ensure that the volume of interest was fully located within the lesion and to obtain optimal homogeneity of the magnetic field. In addition, water-unsuppressed spectra (16 averages) were acquired from the same volume of interest for eddy current correction, absolute quantification of metabolite signals, and determination of full width at half maximum of the unsuppressed water peak (FWHM water). Metabolite concentrations of choline-containing compounds (Cho) were computed using the LCModel program and correlated with MIB-1 as a proliferative cell index from a tissue specimen.
In 16 patients harboring macroadenomas without hemorrhage, there was a strong positive linear correlation between metabolite concentrations of Cho and the MIB-1 proliferative cell index (R = 0.819, p < 0.001). The metabolite concentrations of Cho ranged from 1.8 to 5.2 mM, and the FWHM water was 4.4-11.7 Hz. Eleven patients had a hemorrhagic adenoma and showed no assignable metabolite concentration of Cho, and the FWHM water was 13.4-24.4 Hz. In 10 patients the size of the lesion was too small (< 20 mm in 2 directions) for the acquisition of MR spectroscopy data.
Quantitative 1H-MR spectroscopy provided important information on the proliferative potential and hemorrhaging of pituitary macroadenomas. These data may be useful for noninvasive structural monitoring of pituitary macroadenomas. Differences in the FWHM water could be explained by iron ions of hemosiderin, which lead to worsened homogeneity of the magnetic field.
本研究旨在将质子磁共振（1H-MR）波谱数据与垂体大腺瘤增殖和出血的组织病理学及手术结果相关联。
对37例垂体大腺瘤患者在1.5-T设备上进行定量1H-MR波谱分析。使用具有128次平均采集次数的点分辨波谱序列（TR 2000毫秒，TE 135毫秒）以及用于水抑制的化学位移选择脉冲。调整体素尺寸以确保感兴趣体积完全位于病变内，并获得磁场的最佳均匀性。此外，从相同感兴趣体积采集未抑制水的波谱（16次平均采集次数）用于涡流校正、代谢物信号的绝对定量以及未抑制水峰半高宽（FWHM水）的测定。使用LCModel程序计算含胆碱化合物（Cho）的代谢物浓度，并与来自组织标本的作为增殖细胞指数的MIB-1相关联。
在16例无出血的大腺瘤患者中，Cho的代谢物浓度与MIB-1增殖细胞指数之间存在强正线性相关性（R = 0.819，p < 0.001）。Cho的代谢物浓度范围为1.8至5.2 mM，FWHM水为4.4 - 11.7 Hz。11例患者患有出血性腺瘤，未显示出可测定的Cho代谢物浓度，FWHM水为13.4 - 24.4 Hz。10例患者的病变尺寸过小（在两个方向上<20 mm），无法采集MR波谱数据。
定量1H-MR波谱分析为垂体大腺瘤的增殖潜能和出血提供了重要信息。这些数据可能有助于垂体大腺瘤的无创结构监测。FWHM水的差异可能由含铁血黄素的铁离子解释，这会导致磁场均匀性变差。
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