Ma Zengyi, He Wenqiang, Zhao Yao, Yuan Jie, Zhang Qilin, Wu Yue, Chen Hong, Yao Zhenwei, Li Shiqi, Wang Yongfei
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China.
Shanghai Pituitary Tumor Center, Shanghai, China.
Neuroradiology. 2016 Jan;58(1):51-7. doi: 10.1007/s00234-015-1591-8. Epub 2015 Sep 16.
It is a common view that consistency and blood supply of pituitary adenoma (PA) can influence the surgical effect. The aim of this study was to determine whether MRI signal intensity (SI) was correlated to the consistency or blood supply of pituitary macroadenoma.
Forty eight pituitary macroadenoma patients were underwent preoperative MRI, including precontrast and contrast-enhanced (CE) T1-spin echo (T1-SE) imaging, CE-sampling perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) imaging, and perfusion-weighted imaging (PWI). The tumor consistency and blood supply were determined by neurosurgeons. The expression of collagen IV and MIB-1 was detected with immunohistology. The correlation of the relative SI (rSI) values (tumor to normal frontal white matter SI) and PWI data to the tumor consistency, blood supply, and the expression level of collagen IV and MIB-1 was statistically studied by Kruskal-Wallis rank test (K-W test).
A significant correlation was observed between the tumor consistency and the rSI on precontrast T1-SE imaging (P = 0.004) but not on CE T1-SE and CE SPACE imaging. The expression of collagen IV was also significantly associated with rSI on T1-SE imaging (P = 0.010). The blood supply was correlated with the relative CBV (rCBV) (P = 0.030). In addition, the expression of MIB-1 was correlated with rSI of CE T1-SE imaging (P = 0.007).
Our results suggest that T1-SE imaging may be a simple and useful method for predicting consistency of PA. CBV value can provide helpful information for assessing the blood supply of pituitary macroadenoma.
垂体腺瘤（PA）的质地和血供会影响手术效果，这是一种普遍观点。本研究旨在确定MRI信号强度（SI）是否与垂体大腺瘤的质地或血供相关。
48例垂体大腺瘤患者术前行MRI检查，包括平扫及增强（CE）T1加权自旋回波（T1-SE）成像、CE-使用不同翻转角演化的应用优化对比度采样完美成像（SPACE）成像及灌注加权成像（PWI）。肿瘤质地和血供由神经外科医生判定。采用免疫组织学方法检测IV型胶原和MIB-1的表达。通过Kruskal-Wallis秩和检验（K-W检验）对相对SI（rSI）值（肿瘤与正常额叶白质SI之比）和PWI数据与肿瘤质地、血供以及IV型胶原和MIB-1表达水平之间的相关性进行统计学研究。
在平扫T1-SE成像上观察到肿瘤质地与rSI之间存在显著相关性（P = 0.004），但在CE T1-SE和CE SPACE成像上未观察到。IV型胶原的表达在T1-SE成像上也与rSI显著相关（P = 0.010）。血供与相对脑血容量（rCBV）相关（P = 0.030）。此外，MIB-1的表达与CE T1-SE成像的rSI相关（P = 0.007）。
我们的结果表明，T1-SE成像可能是预测PA质地的一种简单且有用的方法。CBV值可为评估垂体大腺瘤的血供提供有用信息。
