Zhao Xuening, Wang Xiaochen, Wang Sihui, Chen Lingxu, Yuan Mengyuan, Sun Shengjun
Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China.
Department of Radiology, Beijing Neurosurgical Institute, Beijing, PR China.
Acta Radiol. 2025 Apr;66(4):441-449. doi: 10.1177/02841851251313555. Epub 2025 Jan 27.
BackgroundPreoperative identification of T-box pituitary transcription factor 19 (TPIT) lineage silent adenomas in non-functioning pituitary adenomas (NFPAs) is important.PurposeTo compare the clinical, laboratory, and radiological features of the three cell lineages of adenomas in NFPAs and evaluate the diagnostic efficacy of multiple microcysts and clivus invasion on magnetic resonance imaging (MRI) for TPIT lineage adenomas in NFPAs.Material and MethodsA total of 405 patients with NFPA were retrospectively enrolled, including steroidogenic factor 1 (SF-1) lineage adenomas (n = 204), TPIT lineage adenomas (n = 111), and pituitary transcription factor 1 (PIT-1) lineage adenomas (n = 90). The clinical, laboratory, and radiological features of the three lineages adenomas were compared. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of multiple microcysts, clivus invasion, and their combination were calculated to diagnose TPIT lineage adenomas in NFPAs.ResultsAmong the three lineages of NFPAs, patients with SF-1 lineage were older than those with TPIT and PIT-1 lineages ( < 0.001). TPIT lineage adenomas were most common in women ( < 0.001) and had the highest tumor volume ( < 0.001), and incidence of clivus invasion ( < 0.001). The multiple microcysts and clivus invasion in the diagnosis of TPIT lineage adenomas in NFPAs had high specificity (88.44% vs. 98.64%) and accuracy (77.28%).ConclusionThe MRI findings of multiple microcysts and clivus invasion can help diagnose TPIT lineage adenomas in NFPAs with high specificity.
背景
术前识别无功能垂体腺瘤（NFPA）中的T-box垂体转录因子19（TPIT）谱系沉默腺瘤很重要。
目的
比较NFPA中三种腺瘤细胞谱系的临床、实验室和放射学特征，并评估磁共振成像（MRI）上多个微囊肿和斜坡侵犯对NFPA中TPIT谱系腺瘤的诊断效能。
材料与方法
回顾性纳入405例NFPA患者，包括类固醇生成因子1（SF-1）谱系腺瘤（n = 204）、TPIT谱系腺瘤（n = 111）和垂体转录因子1（PIT-1）谱系腺瘤（n = 90）。比较三种谱系腺瘤的临床、实验室和放射学特征。计算多个微囊肿、斜坡侵犯及其联合诊断NFPA中TPIT谱系腺瘤的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。
结果
在NFPA的三种谱系中，SF-1谱系患者比TPIT和PIT-1谱系患者年龄大（<0.001）。TPIT谱系腺瘤在女性中最常见（<0.001），肿瘤体积最大（<0.001），斜坡侵犯发生率最高（<0.001）。多个微囊肿和斜坡侵犯在诊断NFPA中TPIT谱系腺瘤时具有较高的特异性（88.44%对98.64%）和准确性（77.28%）。
结论
多个微囊肿和斜坡侵犯的MRI表现有助于高特异性地诊断NFPA中的TPIT谱系腺瘤。
