3D-SPACE序列在垂体腺瘤术前评估中的应用

Application of preoperative pituitary adenoma evaluated by 3D-SPACE sequence

目的探讨三维可变翻转角快速自旋回波序列(3D-SPACE)在垂体腺瘤诊断及海绵窦侵袭性术前评估中的应用价值。方法回顾性分析50例垂体大腺瘤和40例垂体微腺瘤患者的增强T_(1)WI和3D-SPACE图像,评估术前两侧海绵窦侵袭性及增强T_(1)WI和3D-SPACE对垂体微腺瘤的检出率,并与手术结果进行比较。结果两位医师对垂体腺瘤与海绵窦边界清晰度评分结果为3D-SPACE序列1.70±0.25,增强T_(1)WI 1.52±0.53(P<0.05)。增强3D-SPACE序列在显示垂体瘤的边缘及评估术前海绵窦侵袭性均优于增强T_(1)WI(灵敏度81.48%vs 66.67%;特异度86.3%vs 67.12%;准确度85%vs 67%)。增强T_(1)WI对垂体微腺瘤的检出率(52.5%)低于增强T_(1)WI联合3D-SAPCE序列(85.0%)。结论与常规增强T_(1)WI相比,增强3D-SPACE对术前评估垂体瘤边界、海绵窦侵袭性和垂体微小病灶的检出均有重要的诊断价值。3D-SPACE序列可作为垂体病变常规MRI的有力补充序列。

Objective To explore the value of three-dimensional sampling perfection with application-optimized contrasts using different flip-angle evolutions(3D-SPACE)sequence in the diagnosis of pituitary adenomas and preoperative assessment of cavernous sinus invasion.Methods The contrast-enhanced(CE)T_(1)WI and 3D-SPACE images of 50 patients with pituitary macroadenoma and 40 patients with pituitary microadenoma were analyzed retrospectively,and the preoperative evaluation of bilateral cavernous sinus invasion and the detection rate of microadenoma by CE T_(1)WI and 3D-SPACE were compared with the surgical findings.Results The two radiologists scored the boundary clarity of pituitary adenoma and cavernous sinus as follows:CE 3D-SPACE 1.70±0.25 vs CE T_(1)WI 1.52±0.53(P<0.05).CE 3D-SPACE was superior to CE T_(1)WI in the display of pituitary adenomas edge and the preoperative assessment of cavernous sinus invasion(sensitivity 81.48%vs 66.67%;specificity 86.3%vs 67.12%,P<0.05;accuracy 85%vs 67%).The detection rate of pituitary microadenomas by CE T_(1)WI was significantly lower than that of CE T_(1)WI combined with 3D-SAPCE(52.5%vs 85%).Conclusion CE 3D-SPACE has important diagnostic value in preoperative assessment of pituitary adenoma edge,cavernous sinus invasion,and detection of pituitary microadenomas.3D-SPACE can be used as a powerful supplementary sequence for conventional MRI of pituitary.