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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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(A) Post-contrast T1-weighted image, coronal plane: the residual tumour demonstrates enhancement pattern exactly the same as normal pituitary gland making correct diagnosis impossible. (B) Pre-contrast T2-weighted image, coronal plane: the intrasellar mass presents with high signal intensity, what indicates residual tumour and excludes recognition of the pituitary gland, which is visible on the left side of the sella (arrow).
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f9-medscimonit-17-10-mt83: (A) Post-contrast T1-weighted image, coronal plane: the residual tumour demonstrates enhancement pattern exactly the same as normal pituitary gland making correct diagnosis impossible. (B) Pre-contrast T2-weighted image, coronal plane: the intrasellar mass presents with high signal intensity, what indicates residual tumour and excludes recognition of the pituitary gland, which is visible on the left side of the sella (arrow).

Mentions: In the cases mentioned above, T2-weighted images revealed the intrasellar mass, which demonstrated high signal intensity that indicated the residual tumor and excluded persistent pituitary gland (Figure 9). The normal pituitary gland has the same signal intensity as brain parenchyma [21,29,30]. The careful assessment of preoperative T2-weighted images in these 3 cases showed that the pituitary adenomas demonstrated exactly the same high intensity signal.


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)

(A) Post-contrast T1-weighted image, coronal plane: the residual tumour demonstrates enhancement pattern exactly the same as normal pituitary gland making correct diagnosis impossible. (B) Pre-contrast T2-weighted image, coronal plane: the intrasellar mass presents with high signal intensity, what indicates residual tumour and excludes recognition of the pituitary gland, which is visible on the left side of the sella (arrow).
© Copyright Policy
Related In: Results  -  Collection

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

f9-medscimonit-17-10-mt83: (A) Post-contrast T1-weighted image, coronal plane: the residual tumour demonstrates enhancement pattern exactly the same as normal pituitary gland making correct diagnosis impossible. (B) Pre-contrast T2-weighted image, coronal plane: the intrasellar mass presents with high signal intensity, what indicates residual tumour and excludes recognition of the pituitary gland, which is visible on the left side of the sella (arrow).
Mentions: In the cases mentioned above, T2-weighted images revealed the intrasellar mass, which demonstrated high signal intensity that indicated the residual tumor and excluded persistent pituitary gland (Figure 9). The normal pituitary gland has the same signal intensity as brain parenchyma [21,29,30]. The careful assessment of preoperative T2-weighted images in these 3 cases showed that the pituitary adenomas demonstrated exactly the same high intensity signal.

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