Ito Miiko, Mitobe Yuta, Hiraka Toshitada, Kanoto Masafumi, Sonoda Yukihiko
Department of Neurosurgery, Yamagata University, Yamagata, Japan.
Department of Diagnostic Radiology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Surg Neurol Int. 2022 Oct 21;13:481. doi: 10.25259/SNI_879_2022. eCollection 2022.
The vascular supply to nonfunctioning pituitary adenomas (NFPAs) differs compared with that of the anterior lobe of the normal pituitary gland. In this study, we aimed to identify feeding arteries and flow dynamics using 3.0 T magnetic resonance imaging (MRI) in NFPAs.
We divided 77 cases of NFPA into three groups according to the time-intensity curve (TIC) pattern by dynamic MRI. We also investigated the presence of feeder arteries as a flow void signal on T2-weighted imaging (T2WI).
According to the TIC, 39 cases demonstrated an ascending pattern, 10 cases demonstrated a descending pattern, and 28 cases demonstrated a monophasic pattern. Tumor size in the ascending group was larger compared with the descending group ( = 0.0036). Flow void signals were identified in 51 of 77 cases (66.2%) on T2WI. Tumor size was larger in tumors with a flow void signal compared with those without ( < 0.0001). Flow void signals were more frequently observed in the group of ascending pattern compared with the group of monophasic and descending pattern ( = 0.032 and = 0.003, respectively). Particularly on the caudal side, the difference between the ascending group and the monophasic and descending groups was remarkable ( = 0.0035 and < 0.0001, respectively).
We successfully evaluated the blood supply pattern by the TIC analysis and identified flow voids using 3.0 T MRI. Blood supply pattern was significantly associated with NFPA size. These results suggested that NFPA hemodynamics changes during tumor growth.
无功能垂体腺瘤(NFPA)的血管供应与正常垂体前叶不同。在本研究中,我们旨在使用3.0 T磁共振成像(MRI)识别NFPA的供血动脉和血流动力学。
我们通过动态MRI根据时间-强度曲线(TIC)模式将77例NFPA分为三组。我们还研究了作为T2加权成像(T2WI)上血流空洞信号的供血动脉的存在情况。
根据TIC,39例表现为上升型,10例表现为下降型,28例表现为单相型。上升组的肿瘤大小比下降组大(= 0.0036)。77例中有51例(66.2%)在T2WI上识别出血流空洞信号。有血流空洞信号的肿瘤比没有的肿瘤大(< 0.0001)。与单相型和下降型组相比,上升型组中血流空洞信号更频繁出现(分别为= 0.032和= 0.003)。特别是在尾侧,上升组与单相型和下降型组之间的差异显著(分别为= 0.0035和< 0.0001)。
我们通过TIC分析成功评估了血液供应模式,并使用3.0 T MRI识别了血流空洞。血液供应模式与NFPA大小显著相关。这些结果表明NFPA在肿瘤生长过程中血流动力学发生变化。