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Are T2-weighted images more useful than T1-weighted contrast-enhanced images in assessment of postoperative sella and parasellar region?

Bladowska J, Biel A, Zimny A, Lubkowska K, Bednarek-Tupikowska G, Sozanski T, Zaleska-Dorobisz U, Sasiadek M - Med. Sci. Monit. (2011)

Bottom Line: Contrast-enhanced T1-weighted imaging was significantly superior to T2-weighted imaging in assessment of infundibulum (p<0.05).T2-weighted images were significantly superior to contrast-enhanced T1-weighted imaging with regard to visualization of contours of residual tumors (p<0.05).T2-weighted images are also very useful for a long time after the resection in the postoperative evaluation of the implanted muscle with fascia.

View Article: PubMed Central - PubMed

Affiliation: Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland. mbladow@wp.pl

ABSTRACT

Background: The proper diagnosis and management of patients after surgery for pituitary tumors are of great importance in clinical practice. The purpose of this study was to investigate the magnetic resonance features of the postoperative sella with fast spin echo T2-weighted imaging and to evaluate the benefits of this sequence compared to the classically performed contrast-enhanced T1-weighted imaging at 1.5T unit.

Material/methods: The study group consisted of 101 patients who underwent resection of pituitary tumors. There were 58 women (57.4%), aged 22 to 75 (mean age, 52.67 years) and 43 men (42.6%), aged 21 to 79 (mean age, 49 years). In all patients preoperative and multiple postoperative MR studies were performed. Post-contrast T1 and pre-contrast T2 images were interpreted by 2 independent readers (neuroradiologists).

Results: Contrast-enhanced T1-weighted imaging was significantly superior to T2-weighted imaging in assessment of infundibulum (p<0.05). There was no statistically significant difference for each of readers between T1- and T2-weighted images regarding to the following features: visualization of residual pituitary gland (p = 0.062 and p = 0.368), contours of pituitary (p = 0.959 and p = 0.265), optic chiasm (p = 0.294 and p = 0.843), and visualization of presence of residual tumor (p = 0.204 and p = 0.169). T2-weighted images were significantly superior to contrast-enhanced T1-weighted imaging with regard to visualization of contours of residual tumors (p<0.05).

Conclusions: T2-weighted images may help to discriminate tumorous from non-tumorous involvement of the postoperative sella and the sphenoid sinus. T2-weighted images are also very useful for a long time after the resection in the postoperative evaluation of the implanted muscle with fascia.

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Visualization of infundibulum: (A) Post-contrast T1-weighted image, coronal plane. (B) Pre-contrast T2-weighted image, coronal plane. In this case the infundibulum is also well delineated on T2-weighted images.
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f8-medscimonit-17-10-mt83: Visualization of infundibulum: (A) Post-contrast T1-weighted image, coronal plane. (B) Pre-contrast T2-weighted image, coronal plane. In this case the infundibulum is also well delineated on T2-weighted images.

Mentions: It is not a surprise that contrast-enhanced T1-weighted imaging was significantly superior to T2-weighted imaging in assessment of infundibulum (p<0.05), which corresponds with data from the literature. Nakasu et al also indicated that the pituitary stalk was less frequently visible on T2-weighted images compared to post-contrast T1 [21]. However, in some of our cases the infundibulum was also well delineated on T2-weighted images (Figure 8). Moreover Nakasu et al claim that contrast-enhanced T1-weighted images had no advantages in demonstration of the optic chiasm, and that post-contrast T1 did not improve the detection of the pituitary gland or its contours [21]. This agrees with our findings.


Are T2-weighted images more useful than T1-weighted contrast-enhanced images in assessment of postoperative sella and parasellar region?

Bladowska J, Biel A, Zimny A, Lubkowska K, Bednarek-Tupikowska G, Sozanski T, Zaleska-Dorobisz U, Sasiadek M - Med. Sci. Monit. (2011)

Visualization of infundibulum: (A) Post-contrast T1-weighted image, coronal plane. (B) Pre-contrast T2-weighted image, coronal plane. In this case the infundibulum is also well delineated on T2-weighted images.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539462&req=5

f8-medscimonit-17-10-mt83: Visualization of infundibulum: (A) Post-contrast T1-weighted image, coronal plane. (B) Pre-contrast T2-weighted image, coronal plane. In this case the infundibulum is also well delineated on T2-weighted images.
Mentions: It is not a surprise that contrast-enhanced T1-weighted imaging was significantly superior to T2-weighted imaging in assessment of infundibulum (p<0.05), which corresponds with data from the literature. Nakasu et al also indicated that the pituitary stalk was less frequently visible on T2-weighted images compared to post-contrast T1 [21]. However, in some of our cases the infundibulum was also well delineated on T2-weighted images (Figure 8). Moreover Nakasu et al claim that contrast-enhanced T1-weighted images had no advantages in demonstration of the optic chiasm, and that post-contrast T1 did not improve the detection of the pituitary gland or its contours [21]. This agrees with our findings.

Bottom Line: Contrast-enhanced T1-weighted imaging was significantly superior to T2-weighted imaging in assessment of infundibulum (p<0.05).T2-weighted images were significantly superior to contrast-enhanced T1-weighted imaging with regard to visualization of contours of residual tumors (p<0.05).T2-weighted images are also very useful for a long time after the resection in the postoperative evaluation of the implanted muscle with fascia.

View Article: PubMed Central - PubMed

Affiliation: Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland. mbladow@wp.pl

ABSTRACT

Background: The proper diagnosis and management of patients after surgery for pituitary tumors are of great importance in clinical practice. The purpose of this study was to investigate the magnetic resonance features of the postoperative sella with fast spin echo T2-weighted imaging and to evaluate the benefits of this sequence compared to the classically performed contrast-enhanced T1-weighted imaging at 1.5T unit.

Material/methods: The study group consisted of 101 patients who underwent resection of pituitary tumors. There were 58 women (57.4%), aged 22 to 75 (mean age, 52.67 years) and 43 men (42.6%), aged 21 to 79 (mean age, 49 years). In all patients preoperative and multiple postoperative MR studies were performed. Post-contrast T1 and pre-contrast T2 images were interpreted by 2 independent readers (neuroradiologists).

Results: Contrast-enhanced T1-weighted imaging was significantly superior to T2-weighted imaging in assessment of infundibulum (p<0.05). There was no statistically significant difference for each of readers between T1- and T2-weighted images regarding to the following features: visualization of residual pituitary gland (p = 0.062 and p = 0.368), contours of pituitary (p = 0.959 and p = 0.265), optic chiasm (p = 0.294 and p = 0.843), and visualization of presence of residual tumor (p = 0.204 and p = 0.169). T2-weighted images were significantly superior to contrast-enhanced T1-weighted imaging with regard to visualization of contours of residual tumors (p<0.05).

Conclusions: T2-weighted images may help to discriminate tumorous from non-tumorous involvement of the postoperative sella and the sphenoid sinus. T2-weighted images are also very useful for a long time after the resection in the postoperative evaluation of the implanted muscle with fascia.

Show MeSH
Related in: MedlinePlus