From the Departments of Neuroradiology.
Neurosurgery.
Invest Radiol. 2022 Sep 1;57(9):567-574. doi: 10.1097/RLI.0000000000000872. Epub 2022 Apr 2.
A prospective preoperative evaluation of 7 T ultra-high-field magnetic resonance imaging (MRI) in patients with suspected pituitary microadenomas for both adenoma detection and intrasellar localization compared with 3 T MRI was carried out.
Patients underwent prospective preoperative standardized 3 and 7 T MRI. A distinct qualitative (lesion detection, intrasellar lesion location) and quantitative (lesion diameters, T1/T2 signal intensity ratio of the lesion to normal pituitary gland tissue) analysis was performed, along with an evaluation of image quality (IQ) regarding overall IQ, anatomical parameters, and artifacts; the findings of the qualitative analysis were compared with intraoperative findings and endocrinological outcomes.
Sixteen patients (mean age, 43 ± 16 years; 13 women) with pituitary microadenomas were included. Using 7 T MRI allowed the detection of 15 microadenomas-3 more than 3 T MRI. In addition, 7 T MRI allowed more precise lesion localization with 93.75% (15/16) agreement with intraoperative findings, compared with 75% (12/16) agreement using 3 T MRI. Lesion diameters showed no significant difference between 3 and 7 T MRI. T1 and T2 signal intensity ratio between microadenomas and normal pituitary gland tissue were higher in 7 T MRI than in 3 T MRI. The overall IQ and the IQ of each anatomical parameter of 7 T MRI were rated higher than those of 3 T MRI. No significant differences in susceptibility or head motion artifacts were observed between 3 and 7 T MRI; however, 7 T MRI was more susceptible to pulsation artifacts.
Ultra-high-field MRI surpasses 3 T MRI in pituitary microadenoma detection and enables more precise delineation with higher correlation with intraoperative findings. Thus, 7 T sellar imaging is a promising option-especially in previously magnetic resonance-negative patients with endocrinologically confirmed hormone oversecretion-and helps reduce the need for invasive diagnostics.
对疑似垂体微腺瘤的患者进行前瞻性术前 7T 超高场磁共振成像（MRI）检查，与 3T MRI 相比，评估其对腺瘤的检出率和鞍内定位。
患者接受前瞻性术前标准的 3T 和 7T MRI 检查。对病变进行定性（病变检出、鞍内病变定位）和定量（病变直径、病变与正常垂体组织的 T1/T2 信号强度比值）分析，并对图像质量（IQ）进行评估，包括总体 IQ、解剖参数和伪影；定性分析的结果与术中发现和内分泌学结果进行比较。
纳入 16 例垂体微腺瘤患者（平均年龄 43±16 岁，13 例女性）。使用 7T MRI 可检测到 15 个微腺瘤，比 3T MRI 多 3 个。此外，7T MRI 能更精确地定位病变，与术中发现的一致性为 93.75%（15/16），而 3T MRI 的一致性为 75%（12/16）。病变直径在 3T 和 7T MRI 之间无显著差异。7T MRI 中微腺瘤与正常垂体组织的 T1 和 T2 信号强度比值高于 3T MRI。7T MRI 的总体 IQ 和每个解剖参数的 IQ 均高于 3T MRI。3T 和 7T MRI 之间的磁化率和头部运动伪影无显著差异；然而，7T MRI 更易受脉动伪影的影响。
超高场 MRI 在垂体微腺瘤的检出方面优于 3T MRI，并能更精确地描绘病变，与术中发现的相关性更高。因此，7T 鞍区成像是一种很有前途的选择，特别是在那些之前磁共振阴性但内分泌学证实激素过度分泌的患者，有助于减少有创诊断的需要。
