钆对比剂在3D-SPACE序列术前评估垂体瘤中的应用

摘要

目的:分析比较增强后3D-SPACE在垂体瘤诊断中的作用,以期优化垂体瘤术前MR评估体系.方法:回顾性分析垂体大腺瘤及ACTH型垂体瘤增强T1-SE、增强3D-SPACE扫描图像,评估两侧海绵窦侵袭情况以及微腺瘤的定位,术前评估结果与手术结果进行分析比较.结果:①增强SPACE序列在垂体瘤边界的显示以及海绵窦侵袭性的诊断中都优于T1-SE序列图像(灵敏度81.8 vs.72.7％;特异度86.2vs.65.6％,P＜0.05;准确度85.0％ vs.67.5％);②单独根据T1-SE序列共检出52.4％的ACTH型垂体微腺瘤,结合增强T1-SE及SAPCE序列共检出病灶81.0％.结论:增强后3D SPACE序列在垂体瘤术前评估其边界、侵袭性及微腺瘤的检出均有重要的诊断价值.%Purpose:To analyze the value of preoperative contrast enhanced (CE) 3D-SPACE sequence in diagnosis of pituitary adenoma.Methods:① CE T1-SE and 3D-SPACE images of pituitary adenoma (＞lcm) and ACTH pituitary microadenoma were retrospectively analyzed.The invasion of cavernous sinus and the microadenoma localization were evaluated on both sequences.Results:① CE 3D-SPACE was superior to T1-SE sequence in assessment of tumor edge and cavernous sinus invasion,the specificity was 86.2％ and 65.6 ％,P＜0.05,and the accuracy was 85.0 and 67.5％,P＜0.05.② CE T1-SE sequence was able to identify ACTH microadenomas in 52.4％ cases,which was significantly lower than that of CE T1-SE and 3D-SPACE (81.0％).Conclusion:CE 3D-SPACE sequence takes an important role in evaluating the characteristics of pituitary macroadenoma and detecting microadenoma preoperatively.