Department of Neurosurgery, Fuzhou 900th Hospital, Fujian Medical University Fuzong Clinical College, Fuzhou 350025, P.R. China.
Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen 361005, P.R. China.
Neurol India. 2021 Jul-Aug;69(4):867-873. doi: 10.4103/0028-3886.325377.
The present study is to investigate the pre- and post-operative magnetic resonance imaging of pituitary tissues following transsphenoidal resection of pituitary macroadenomas, as well as its clinical significance.
The medical records of 108 consecutive pituitary macroadenoma patients admitted at Fuzhou 900th Hospital between September 2012 and September 2014 were retrospectively reviewed. Siemens 3. 0T magnetic resonance scanner was used to perform pre- and postoperative MRI scanning, including plain scan and contrast-enhanced scan of SE sequential T1WI and T2WI in sagittal, coronal and axial views. PACS medical imaging system was used to measure the diameter of pituitary adenoma, as well as the volumes of the adenoma and pituitary tissue. Hematoxylin-eosin staining and immunohistochemical staining were also performed.
Higher height of pituitary adenoma results in lower rate of posterior pituitary bright spot (PPBS) on MR T1-weighted imaging. Preoperative MR signal intensity of PPBS was negatively related to diabetes insipidus (DI). Normal pituitary tissues were likely to be above the pituitary adenomas in growth hormone-secreting adenoma patients, while mostly located aside in gonadotropin-secreting adenoma patients. Morphological restitution of postoperative pituitary tissues was better in lateral displacement than that in superior or superolateral patterns on pre-operative MR images. Positive rate of PPBS on preoperative MRI is negatively related to adenoma height, and the signal intensity of PPBS is inversely related to postoperative DI.
The relative locations of pituitary tissues and adenoma tissues may be associated with the adenoma type and may affect the postoperative remodeling of residual pituitary tissues.
本研究旨在探讨经蝶窦切除垂体大腺瘤前后的垂体组织磁共振成像及其临床意义。
回顾性分析 2012 年 9 月至 2014 年 9 月福州 900 医院收治的 108 例垂体大腺瘤患者的病历资料。采用西门子 3.0T 磁共振扫描仪进行术前、术后 MRI 扫描,包括 SE 序列 T1WI 和 T2WI 矢状位、冠状位和轴位平扫和增强扫描。使用 PACS 医学影像系统测量垂体腺瘤直径以及腺瘤和垂体组织体积。行苏木精-伊红染色和免疫组织化学染色。
垂体腺瘤高度越高,MR T1 加权成像上后叶垂体亮点(PPBS)的出现率越低。PPBS 术前 MR 信号强度与尿崩症(DI)呈负相关。生长激素分泌性腺瘤患者的正常垂体组织多位于瘤体上方,促性腺激素分泌性腺瘤患者的正常垂体组织多位于瘤体旁侧。术前 MR 图像中垂体组织的侧方移位较上方或上外侧移位更有利于术后垂体组织的形态恢复。术前 MRI 上 PPBS 的阳性率与腺瘤高度呈负相关,PPBS 的信号强度与术后 DI 呈负相关。
垂体组织和腺瘤组织的相对位置可能与腺瘤类型有关,并可能影响残留垂体组织的术后重塑。