Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China.
Department of Neurosurgery, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China.
Eur J Radiol. 2019 Jan;110:219-224. doi: 10.1016/j.ejrad.2018.12.002. Epub 2018 Dec 6.
To explore the value of magnetic resonance textural analysis (MRTA) in assessing consistency of pituitary macroadenoma (PMA) based on contrast enhanced (CE) three-dimensional sampling perfection with application-optimized contrasts by using different flip angle evolution (3D-SPACE) images.
Fifty-three patients with PMAs that underwent CE 3D-SPACE scanning by 3.0 T MRI and endoscopic trans-sphenoidal surgery were included in the present study. Consistency levels of PMAs were evaluated intraoperatively by two neurosurgeons. Each resection specimen was stained with H&E and anti-collagen IV. MRTA was conducted and texture features were calculated. An unpaired t-test was used to analyze the differences of texture features between soft and hard PMAs. ROC curves by individual and combined features were used to calculate the diagnostic accuracy of MRTA in predicting PMA consistency.
First-order energy and second-order correlation negatively correlated with hard PMAs, while first-order entropy and second-order variance, sum variance, and sum entropy positively correlated with stiffness. All showed significant differences between soft and hard PMAs (P < 0.05). Diagnostic accuracy of combined negative features could achieve an AUC of 0.819, sensitivity of 88.9%, specificity of 61.5%, PPV of 70.6%, NPV of 84.2% and positive features could achieve an AUC of 0.836, sensitivity of 85.2%, specificity of 69.2%, PPV of 74.2%, NPV of 81.8% (P < 0.001).
MRTA using CE 3D-SPACE images is helpful for assessing PMA consistency preoperatively and noninvasively.
探讨对比增强（CE）三维采样完美应用优化对比（3D-SPACE）不同翻转角演化（3D-SPACE）图像在评估垂体大腺瘤（PMA）一致性方面磁共振纹理分析（MRTA）的价值。
本研究纳入 53 例经 3.0T MRI 增强 CE 3D-SPACE 扫描并经鼻内镜经蝶窦手术的 PMA 患者。由两名神经外科医生在术中评估 PMA 的一致性水平。每个切除标本均用 H&E 和抗胶原 IV 染色。进行 MRTA 并计算纹理特征。采用配对 t 检验分析软、硬 PMA 之间纹理特征的差异。采用个体和联合特征的 ROC 曲线计算 MRTA 预测 PMA 一致性的诊断准确性。
一阶能量和二阶相关与硬 PMA 呈负相关，而一阶熵和二阶方差、和方差和和熵与硬度呈正相关。所有这些特征在软、硬 PMA 之间均有显著差异（P<0.05）。联合负特征的诊断准确性可达到 AUC 为 0.819、敏感性为 88.9%、特异性为 61.5%、PPV 为 70.6%、NPV 为 84.2%，阳性特征的 AUC 为 0.836、敏感性为 85.2%、特异性为 69.2%、PPV 为 74.2%、NPV 为 81.8%（P<0.001）。
CE 3D-SPACE 图像的 MRTA 有助于术前非侵入性评估 PMA 的一致性。
