Department of PediatricsIstituto Giannina Gaslini, University of Genoa, Genoa, Italy.
Pediatric Neuroradiology UnitIstituto Giannina Gaslini, Genoa, Italy.
Eur J Endocrinol. 2018 Jun;178(6):613-622. doi: 10.1530/EJE-18-0094. Epub 2018 Apr 12.
To investigate the role of T2-DRIVE MRI sequence in the accurate measurement of pituitary stalk (PS) size and the identification of PS abnormalities in patients with hypothalamic-pituitary disorders without the use of gadolinium.
This was a retrospective study conducted on 242 patients who underwent MRI due to pituitary dysfunction between 2006 and 2015. Among 135 eligible patients, 102 showed eutopic posterior pituitary (PP) gland and 33 showed 'ectopic' PP (EPP).
Two readers independently measured the size of PS in patients with eutopic PP at the proximal, midpoint and distal levels on pre- and post-contrast T1-weighted as well as T2-DRIVE images; PS visibility was assessed on pre-contrast T1 and T2-DRIVE sequences in those with EPP. The length, height, width and volume of the anterior pituitary (AP), PP height and length and PP area were analyzed.
Significant agreement between the two readers was obtained for T2-DRIVE PS measurements in patients with 'eutopic' PP; a significant difference was demonstrated between the intraclass correlation coefficient calculated on the T2-DRIVE and the T1-pre- and post-contrast sequences. The percentage of PS identified by T2-DRIVE in EPP patients was 72.7% compared to 30.3% of T1 pre-contrast sequences. A significant association was found between the visibility of PS on T2-DRIVE and the height of AP.
T2-DRIVE sequence is extremely precise and reliable for the evaluation of PS size and the recognition of PS abnormalities; the use of gadolinium-based contrast media does not add significant information and may thus be avoided.
探讨 T2-DRIVE 磁共振成像（MRI）序列在不使用钆对比剂的情况下，准确测量垂体柄（PS）大小并识别下丘脑-垂体疾病患者 PS 异常的作用。
这是一项回顾性研究，纳入了 2006 年至 2015 年间因垂体功能障碍接受 MRI 检查的 242 例患者。在 135 例符合条件的患者中，102 例显示正常的后叶垂体（PP），33 例显示“异位”PP（EPP）。
两位读者分别在 T1 加权像的对比前和对比后，以及 T2-DRIVE 图像上，对正常 PP 的患者 PS 近端、中点和远端进行独立测量；对 EPP 的患者，在 T1 加权像和 T2-DRIVE 序列的对比前，评估 PS 的可见性。分析垂体前叶（AP）的长度、高度、宽度和体积、PP 高度和长度以及 PP 面积。
在“正常”PP 的患者中，T2-DRIVE PS 测量值得到了两位读者的显著一致性；T2-DRIVE 计算的组内相关系数与 T1 对比前和对比后序列之间存在显著差异。与 T1 对比前序列（30.3%）相比，EPP 患者 T2-DRIVE 识别 PS 的百分比为 72.7%。PS 在 T2-DRIVE 上的可见性与 AP 的高度之间存在显著关联。
T2-DRIVE 序列对于 PS 大小的评估和 PS 异常的识别极为精确和可靠；使用基于钆的对比剂并不能增加显著的信息，因此可以避免使用。
