Andrea Romano1,2, Valeria Coppola3, Mariangela Lombardi4, Luigi Lavorato5, Domenica Di Stefano4, Emanuela Caroli5, Maria Camilla Rossi Espagnet6,7, Francesca Tavanti6, Giuseppe Minniti8, Giuseppe Trillò5, Alessandro Bozzao6. 1. Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy. andrea.romano@uniroma1.it. 2. Department of Odontostomatological and Maxillo-Facial Sciences, Umberto I Hospital, University Sapienza, Rome, Italy. andrea.romano@uniroma1.it. 3. Department of Neuroradiology, S. Carlo Hospital, Potenza, Italy. 4. Department of Histopathology, S. Andrea Hospital, University Sapienza, Rome, Italy. 5. Department of Neurosurgery, S. Andrea Hospital, University Sapienza, Rome, Italy. 6. Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy. 7. Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, Rome, Italy. 8. Department of Radiotherapy, S. Andrea Hospital, University Sapienza, Rome, Italy.
Abstract
PURPOSE: Our hypothesis was that pituitary macroadenomas show different areas of consistency detectable by enhanced magnetic resonance imaging (MRI) with Dynamic study during gadolinium administration. MATERIALS AND METHODS: We analysed 21 patients with pituitary macroadenomas between June 2013 and June 2015. All patients underwent trans-sphenoidal surgery and neurosurgeon described macroadenomas consistency. Similarly, two neuroradiologists manually drew regions of interest (ROIs) inside the solid-appearing portions of macroadenoma and in the normal white matter both on dynamic and post-contrast acquisitions. The ratio between these ROIs, defined as Signal Intensity Ratio (SIR), allowed obtaining signal intensity curves over time on dynamic acquisition and a single value on post-contrast MRI. SIR values best differentiating solid from soft macroadenoma components were calculated and correlated with pathologic patterns. A two-sample T test and empiric receiver operating characteristic (ROC) curve of SIR was performed. RESULTS: According to ROC analysis, the SIR value of 1.92, obtained by dynamic acquisition, best distinguished soft and hard components. All the specimens from soft components were characterized by high cellularity, high representation of vascularization and micro-haemorrhage and low percentage of collagen content. The reverse was evident in hard components. CONCLUSIONS: We demonstrated that dynamic MRI acquisition could distinguish with good accuracy macroadenomas consistency.
PURPOSE: Our hypothesis was that pituitary macroadenomas show different areas of consistency detectable by enhanced magnetic resonance imaging (MRI) with Dynamic study during gadolinium administration. MATERIALS AND METHODS: We analysed 21 patients with pituitary macroadenomas between June 2013 and June 2015. All patients underwent trans-sphenoidal surgery and neurosurgeon described macroadenomas consistency. Similarly, two neuroradiologists manually drew regions of interest (ROIs) inside the solid-appearing portions of macroadenoma and in the normal white matter both on dynamic and post-contrast acquisitions. The ratio between these ROIs, defined as Signal Intensity Ratio (SIR), allowed obtaining signal intensity curves over time on dynamic acquisition and a single value on post-contrast MRI. SIR values best differentiating solid from soft macroadenoma components were calculated and correlated with pathologic patterns. A two-sample T test and empiric receiver operating characteristic (ROC) curve of SIR was performed. RESULTS: According to ROC analysis, the SIR value of 1.92, obtained by dynamic acquisition, best distinguished soft and hard components. All the specimens from soft components were characterized by high cellularity, high representation of vascularization and micro-haemorrhage and low percentage of collagen content. The reverse was evident in hard components. CONCLUSIONS: We demonstrated that dynamic MRI acquisition could distinguish with good accuracy macroadenomas consistency.
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