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MRI features of pituitary adenoma apoplexy and their relationship with hypoxia, proliferation, and pathology

Jianwu Wu1, Songyuan Li2, Yinxing Huang1

  • 1Department of Neurosurgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China.

Journal of Clinical Ultrasound : JCU
|May 26, 2023
PubMed
Abstract

Insights

Pituitary adenoma apoplexy shows distinct MRI features. The cystic group exhibits less hypoxia but stronger proliferation compared to the parenchymal group.

Area of Science:

  • Neuroradiology
  • Endocrinology
  • Pathology

Background:

  • Pituitary adenoma (PA) apoplexy is a clinical emergency.
  • Understanding MRI features associated with PA apoplexy is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the relationship between MRI characteristics of pituitary adenoma apoplexy and underlying hypoxia, proliferation, and pathological features.
  • To differentiate between parenchymal and cystic types of PA apoplexy based on MRI findings.

Main Methods:

  • Sixty-seven patients with PA apoplexy were classified into parenchymal and cystic groups based on MRI criteria (T2WI, T1WI enhancement).
  • Quantitative MRI parameters (rT1WI enhancement, rT2WI values) were measured.
  • Immunohistochemistry and Western blot were used to assess protein levels of hypoxia-inducible factor-1 (HIF-1α), pyruvate dehydrogenase kinase 1 (PDK1), and Ki67.
  • Nuclear morphology was evaluated using HE staining.

Main Results:

  • The parenchymal group showed significantly lower rT1WI enhancement, rT2WI values, Ki67 expression, and abnormal nuclear morphology compared to the cystic group.
  • The parenchymal group exhibited significantly higher protein expression levels of HIF-1α and PDK1 than the cystic group.
  • HIF-1α positively correlated with PDK1 and negatively correlated with Ki67.

Conclusions:

  • The cystic group of PA apoplexy experiences less ischemia and hypoxia but demonstrates stronger cellular proliferation compared to the parenchymal group.
  • MRI features can help infer the degree of hypoxia and proliferation in PA apoplexy.
  • These findings may have implications for understanding PA apoplexy pathogenesis and guiding treatment strategies.
Keywords:
HIF-1αKi67MRIPDK1pituitary adenoma

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