垂体微腺瘤动态增强MRI的临床应用

Dynamic enhanced MRI imaing in disgnosis of pituitary microadenomas with prolactin (PRL) secretion

目的评价垂体微腺瘤动态增强MBI的临床应用价值.方法回顾性分析48例经手术或临床证实的泌乳激素(PRL)分泌型垂体微腺瘤的动态增强MRI资料,并经处理后获得其对比增强率-时间(CER-T)曲线类型和增强峰值(EP),将其检出率与常规平扫及常规增强扫描微腺瘤的检出率进行比较.结果48例微腺瘤CER-T曲线类型分布:Ⅰ型0例,Ⅱ型7例,Ⅲ型6例,Ⅳ型19例和Ⅴ型16例.微腺瘤EP值在90～180 s内13例,在180 s以后25例.动态增强MRI检出率为95.8%(46/48),其中60 s时腺瘤与正常垂体对比效果最为明显,检出效率为58.3%(28/48).常规平扫检出率为25.0%(12/48).常规增强MRI检出率为52.1%(25/48).行×列x2检验,P＜0.01.结论动态增强扫描是诊断PRL分泌型垂体微腺瘤的可靠方法,临床和实验室检查怀疑PRL型微腺瘤而MRI平扫阴性者,动态MRI应列为常规检查.

[objective] To investigate the use of dynamic enhanced MRI imaging in evaluation of pituitary microadenomas. [Methods] The MRI date of 48 patients with PRL secretion pituitary microadenomas proved by operation or clinical findings were retrospectively studied by radiologists, compare diagnostic rate of dynamic enhanced MRI with conventional contrast enhanced MRI and unenhanced MRI. The contrast enhancement ratio-time (CER-T) curves type and enhancement (EP) were obtained by postprocessing. [Results] The CER-T curves type as follows: The type I in 0 case, type II in 7 cases, type III in 6 cases, type IV in 19 cases and type V in 16 cases. EP during 90~180 s was 13 cases and 25 cases over 180 s. The diagnostic rate of dynamic enhanced MRI was 95.8% (46/48), among 58.3% (28/48) in 60 s. The diagnostic rate of conventional enhanced MRI and unenhanced MRI was 52.1% (25/48) and 25.0% (12/48), (P<0.01). [Conclusions] Dynamic enhanced MRI is valuable in diagnosing PRL secrection pituitary microadenomas, so it should become routine examination of PRL secrection pituitary microadenomas which is suspected by clinic or laboratory finding but negative in conventional MRI.