Department of Radiology, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, Guangdong, China.
Shenzhen University School of Medicine, Shenzhen, Guangdong, China.
Eur Radiol. 2021 Nov;31(11):8187-8196. doi: 10.1007/s00330-021-07878-x. Epub 2021 Apr 24.
This study was to investigate clinical applicability of diffusion spectrum imaging (DSI) for quantitative detection of visual pathway abnormalities to predict the degree of visual field defects (VFD) in patients with pituitary adenomas.
Sixty-five patients with pituitary adenomas and 33 healthy controls underwent conventional MRI and DSI scanning that allowed high-angular-resolution fiber tracking. Optic chiasmal compression and VFD were confirmed in all patients via radiological and neuro-ophthalmological examinations. Quantitative assessments of chiasmal lift, VFD, and DSI parameters from the optic nerve, optic tract, and optic radiation were performed. Group comparisons and correlation analyses were conducted in patients and controls. Using the 5-fold cross-validation method, the support vector machine classifiers were constructed to predict the degree of visual defects.
The mean values of quantitative anisotropy and generalized fractional anisotropy in optic nerve and optic tract showed significant differences between patients and controls (p < 0.05). These parameters were also significantly correlated with the chiasmal lift distance and degree of visual defects (p < 0.05). All patients were divided into mild (n = 42) and severe (n = 23) VFD groups, using the mean deviation value of -8 dB as the threshold. The classifiers achieved an accuracy of 0.83, sensitivity of 0.78, and specificity of 0.86 to discriminate patients with mild and severe visual defects.
Using high-angular-resolution fiber tracking, DSI may provide quantitative information to detect visual pathway abnormalities and be a potential diagnostic tool for determining the degree of visual field defects in pituitary adenomas.
• Abnormal QA and GFA values of optic nerve and optic tract in adenoma patients • Close relationship between DSI parameters and VFD degree in adenoma patients • The classifiers achieved an accuracy of 0.83, sensitivity of 0.78, and specificity of 0.86 to discriminate patients with mild and severe VFD.
本研究旨在探讨扩散谱成像（DSI）在定量检测视路异常以预测垂体腺瘤患者视野缺损（VFD）程度中的临床应用价值。
65 例垂体腺瘤患者和 33 名健康对照者接受了常规 MRI 和 DSI 扫描，允许进行高角度分辨率纤维跟踪。所有患者均通过影像学和神经眼科检查证实视交叉受压和 VFD。对视神经、视束和视辐射的视交叉抬高、VFD 和 DSI 参数进行定量评估。在患者和对照组中进行组间比较和相关性分析。使用 5 倍交叉验证方法构建支持向量机分类器，以预测视觉缺陷程度。
视神经和视束的定量各向异性和广义各向异性均值在患者和对照组之间存在显著差异（p < 0.05）。这些参数与视交叉抬高距离和视觉缺陷程度也呈显著相关（p < 0.05）。所有患者均根据平均偏差值-8 dB 分为轻度（n = 42）和重度（n = 23）VFD 组。分类器对轻度和重度 VFD 患者的准确率为 0.83，灵敏度为 0.78，特异性为 0.86。
使用高角度分辨率纤维跟踪，DSI 可以提供定量信息来检测视路异常，并可能成为确定垂体腺瘤患者 VFD 程度的一种潜在诊断工具。
• 腺瘤患者视神经和视束 QA 和 GFA 值异常• DSI 参数与 VFD 程度在腺瘤患者中密切相关• 分类器对轻度和重度 VFD 患者的准确率为 0.83，灵敏度为 0.78，特异性为 0.86。
