From the Division of Neuroradiology (A.A.A.), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Department of Medical Imaging (P.B.H.), King Abdulaziz Medical City NGHA, Riyadh, Saudi Arabia.
AJNR Am J Neuroradiol. 2022 Jul;43(7):1024-1028. doi: 10.3174/ajnr.A7554. Epub 2022 Jun 23.
The use of gadolinium-based contrast agents contributes to the cost of MR imaging and prolongs image-acquisition time. There are also recent concerns regarding gadolinium deposition, particularly in patients who require frequent follow-up MRIs. The purpose of this study was to assess whether gadolinium-based contrast agents are needed during MR imaging follow-up for unoperated pituitary macroadenoma.
A total of 105 patients with unoperated pituitary macroadenoma who underwent follow-up MR imaging of the sella were included in this retrospective study. The craniocaudal dimension, cavernous sinus invasion grading, and optic pathway compression were assessed independently on coronal T2WI and compared with coronal T1-weighted images with gadolinium-based contrast agents (T1 postcontrast images). The agreement between the T2WI and T1 postcontrast images for the craniocaudal dimension was assessed using the intraclass correlation coefficient; for the cavernous sinus invasion and optic pathway compression, it was assessed using κ statistics.
There was excellent agreement for the craniocaudal dimensions between T2WI and T1 postcontrast images (intraclass correlation coefficient = 0.96, < .001; 95% CI, 0.84-0.99). Additionally, there was almost-perfect agreement between cavernous sinus invasion and optic pathway compression between T2WI and T1 postcontrast images, with κ = 0.95 and 0.84, respectively (< .001).
MR imaging of the sella without the use of gadolinium-based contrast agents could potentially be considered for the follow-up of unoperated pituitary macroadenomas. This choice can reduce the MR imaging examination cost and acquisition time and avoids potential adverse effects of gadolinium-based contrast agents.
钆基造影剂的使用增加了磁共振成像的成本并延长了图像采集时间。此外，最近还出现了对钆沉积的担忧，尤其是在需要频繁进行磁共振成像随访的患者中。本研究旨在评估在未手术的垂体大腺瘤的磁共振成像随访中是否需要使用钆基造影剂。
本回顾性研究共纳入 105 例接受鞍区磁共振成像随访的未手术垂体大腺瘤患者。在冠状 T2WI 上独立评估颅尾径、海绵窦侵袭分级和视路压迫，并与冠状 T1 加权图像（含钆基造影剂的 T1 增强图像）进行比较。采用组内相关系数评估 T2WI 与 T1 增强图像的颅尾径之间的一致性；采用 κ 统计评估海绵窦侵袭和视路压迫的一致性。
T2WI 与 T1 增强图像的颅尾径之间具有极好的一致性（组内相关系数=0.96，<0.001；95%置信区间，0.84-0.99）。此外，T2WI 与 T1 增强图像之间的海绵窦侵袭和视路压迫具有几乎完美的一致性，κ 值分别为 0.95 和 0.84（<0.001）。
对于未手术的垂体大腺瘤的随访，可以考虑不使用钆基造影剂进行鞍区磁共振成像。这样的选择可以降低磁共振成像检查的成本和采集时间，并避免钆基造影剂的潜在不良反应。
