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Increased diagnostic confidence in the diagnosis of pituitary micro-lesions with the addition of three-dimensional

Ying Tang1, Yue Wu1, Hua Zhang1

  • 1Department of Radiology, Huashan Hosptial, Fudan University, Shanghai 200040, PR China.

Acta Radiologica (Stockholm, Sweden : 1987)
|May 25, 2018
PubMed
Abstract

Insights

Three-dimensional sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-T2 SPACE) sequences significantly improve diagnostic confidence for pituitary micro-lesions. This advanced MRI technique enhances detection of small lesions compared to conventional methods.

Area of Science:

  • Radiology
  • Medical Imaging
  • Neuroimaging

Background:

  • Conventional MRI techniques face limitations in diagnosing pituitary micro-lesions due to slice thickness and partial volume effects.
  • These limitations can lead to missed or inaccurate diagnoses of small pituitary abnormalities.
  • Pituitary micro-lesions require high-resolution imaging for accurate detection and characterization.

Purpose of the Study:

  • To assess the diagnostic performance of 3D-T2 SPACE sequences compared to standard MRI protocols for pituitary micro-lesions.
  • To evaluate the added value of 3D-T2 SPACE in improving the detection and confidence of diagnosing small pituitary lesions.
  • To compare the conspicuity and inter-observer agreement of 3D-T2 SPACE with conventional MRI sequences.

Main Methods:

  • Retrospective analysis of MRI findings in 664 patients with suspected pituitary lesions.
  • Coronal 3D-T2 SPACE sequences were acquired, followed by T1-weighted imaging.
  • Conventional sequences included coronal/sagittal T1W and post-contrast enhanced T1 imaging; images were reviewed by two neuroradiologists.

Main Results:

  • The addition of 3D-T2 SPACE sequences increased diagnostic confidence for pituitary micro-lesions by 60.3%.
  • Lesion conspicuity scores were significantly higher with combined 3D-T2 SPACE and conventional sequences compared to conventional imaging alone.
  • 3D-T2 SPACE sequences demonstrated good inter-observer agreement (kappa = 0.826).

Conclusions:

  • Post-contrast enhanced 3D-T2 SPACE sequences, when combined with routine MRI, significantly enhance diagnostic confidence for pituitary micro-lesions.
  • This advanced sequence is effective for detecting small adenomas, lesions near the cavernous sinus or sellar floor, and those with early enhancement.
  • 3D-T2 SPACE is a valuable tool for improving the diagnosis of challenging pituitary micro-lesions.
Keywords:
3D-T2 SPACEmicro-lesionspituitary gland

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