期刊
CLINICAL ENDOCRINOLOGY
卷 96, 期 4, 页码 578-588出版社
WILEY
DOI: 10.1111/cen.14574
关键词
Cushing disease; diagnosis; magnetic resonance imaging; microadenoma; pituitary ACTH hypersecretion; pituitary adenoma; SPACE sequence
资金
- National Natural Science Foundation of China [81702467]
- Shanghai Rising-Star Program [12QH1400400]
- China National Funds for Distinguished Young Scientists [81725011]
Combining contrast-enhanced SPACE with DCE T1-SE sequence improves the detection rate of ACTH-secreting pituitary microadenomas, especially as a supplementary sequence when T1-SE sequence results are negative or equivocal.
Objective Cushing disease is a potentially fatal endocrine disorder caused by adrenocorticotropin (ACTH)-secreting microadenomas in the pituitary gland. Accurate detection and localization of the adenomas is the key to clinical treatment. This study analysed the value of contrast-enhanced Sampling Perfection with Application-optimized Contrasts using different flip angle Evolutions (SPACE) sequence in magnetic resonance imaging (MRI) assessment of ACTH-secreting pituitary microadenomas. Design and Patients We carried out a retrospective study in which 45 patients with ACTH-secreting pituitary microadenomas were enrolled. Dynamic contrast-enhanced (DCE) coronal T1-SE sequence was performed. A contrast-enhanced coronal SPACE sequence was added immediately after DCE MRI finished. Two independent observers assessed the tumour existence and location, then the results were compared with surgical findings. Results Twenty-four lesions (53.3%) were detected by the DCE T1-SE sequence alone, while 35 lesions (80.0%) were detected with the addition of contrast-enhanced SPACE sequence. The sensitivity (58.5% vs. 85.3%; p < .05) and best diagnostic accuracy (62.0% vs. 84.4%; p < .05) were significantly better for addition with SPACE sequence than DCE-SE images alone in detection of ACTH-secreting pituitary microadenomas. For lesions <5 mm, the detected numbers were 4 (16.6%) versus 10 (27.8%) by DCE T1-SE sequence and combined DCE T1-SE with SPACE sequence. Conclusions A combination of contrast-enhanced SPACE with DCE T1-SE sequence could improve the detection of ACTH-secreting pituitary microadenomas. Contrast-enhanced SPACE sequence could be a supplementary sequence for imaging of ACTH-secreting pituitary adenomas when T1-SE sequence provides negative or equivocal findings.
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