MRI半量动态增强在垂体微腺瘤诊断中的应用

Dynamic contrast-enhanced MRI scan with a half-dose Gd-DTPA in diagnosis of pituitary microadenomas

目的:探讨MRI半量动态增强扫描在垂体微腺瘤诊断中的应用价值。方法:回顾性分析对临床及实验室检查诊断并手术治疗或诊断性治疗为垂体微腺瘤的67例患者先行平扫(67例),然后行全量(37例)及半量(30例)Gd-DTPA动态增强扫描,比较两种动态增强扫描方法在显示垂体微腺瘤的敏感性。结果:平扫、全量和半量Gd-DTPAMRI动态增强扫描的检出率分别为50.8%(34/67)、75.7%(28/37)和90.0%(27/30),分别比较平扫与全量、全量与半量扫描有统计学差异(P<0.01、P<0.05)。结论:MRI平扫及全量、半量Gd-DTPA动态增强扫描比较,可依次增加垂体微腺瘤显示的敏感性。其中以半量Gd-DTPAMRI动态增强扫描对病灶检出率最高,可作为MRI诊断垂体微腺瘤的首选强化方法。

Objective To explore the diagnostic value of dynamic contrast-enhanced MRI scan with a half-dose Gd-DTPA in pituitary microadenomas. Methods The data on 67 patients who had been diagnosed as pituitary microadenoma based on both laboratory tests and clinical manifestations and had then underwent dynamic contrastenhanced MRI scans with a full-（37 cases） or half-dose （30 cases） Gd-DTRA following plain scans were retrospectively analysed. The sensitivity of the two enhanced MRI scanning methods for pituitary microadenoma was compared. Results The detection rate of pituitary microadenomas was 50.8% （34/67） by plain scan, 75.7% （28/37） by a full-dose Gd-DTPA enhancement, and 90.0%（27/30） by a half-dose, revealing a significant difference between plain scan and a full-dose contrast enhancement （P 〈 0.01）, or between a full-dose and a half-dose enhancement （P 〈 0.05）. Conclusion Of the three methods, dynamic contrast-enhanced MRI scan with a half-dose Gd-DTPA has the highest sensitivity in detecting pituitary microadenomas and thus should be considered as the primary option for diagnosing these intrapituitary tumors.