改善了先前未接受过治疗的上腺皮质激素 (ACTH) 依赖的库辛综合征的非侵入性诊断评估
1Department of Radiology, Peking Union Medical College Hospital, Chinese Academe of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng Distinct, Beijing, 100730, China.
BMC medical imaging
|July 2, 2025
概括
用高分辨率MRI (hrMRI) 进行高剂量德克萨米他抑制试验 (HDDST) 能够准确诊断依赖上皮质激素 (ACTH) 的库辛综合征. 这种非侵入性方法超过了针对瘤定位的侵入性双边下层鼻抽样 (BIPSS).
科学领域:
- 内分泌学 在内分泌学.
- 放射学 放射学是一门学科.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 库辛综合征的诊断依赖于上皮质激素 (ACTH) 的上皮质激素依赖于侵入性的双边下皮质鼻腔采样 (BIPSS).
- 在瘤横向化准确性和侵入性方面,BIPSS存在局限性.
- 需要进行非侵入性诊断评估,以改善患者的治疗结果.
研究的目的:
- 为了评估ACTH依赖的库辛综合征的非侵入性方法的诊断性能.
- 为了比较高剂量甲抑制试验 (HDDST) 与不同MRI技术相结合的准确性,与BIPSS进行瘤横向化.
主要方法:
- 对95名患有ACTH依赖的库辛综合征的患者进行了回顾性分析.
- 在HDDST+常规MRI (cMRI),HDDST+动态MRI (dMRI),HDDST+高分辨率MRI (hrMRI) 和BIPSS之间对诊断性能进行比较.
- 对垂体腺瘤识别和瘤横向化准确性的敏感性评估.
主要成果:
- HDDST + hrMRI显示的诊断性能与BIPSS相提并论 (AUC为0.95-0.98与0.98).
- 对于HDDST + hrMRI (90.6-95.3%) 的瘤横向化的准确性明显高于BIPSS (24.7%).
- HDDST + hrMRI 在确定瘤位置方面表现出卓越的准确性.
结论:
- HDDST + hrMRI是一种非常有效的非侵入性诊断工具,用于治疗依赖ACTH的库辛综合征.
- 这种综合方法提供了与BIPSS相比的诊断性能.
- 与BIPSS相比,HDDST + hrMRI显著提高了瘤横向化的准确性.
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