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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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The fluid collection on the right side of the sphenoid sinus – excellently visible on T2 (arrow). (A) Post-contrast T1-weighted image, coronal plane. (B) Pre-contrast T2-weighted image, coronal plane.
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f10-medscimonit-17-10-mt83: The fluid collection on the right side of the sphenoid sinus – excellently visible on T2 (arrow). (A) Post-contrast T1-weighted image, coronal plane. (B) Pre-contrast T2-weighted image, coronal plane.

Mentions: Sometimes the residual tumor may present on post-contrast T1-weighted images with the same signal intensity as postoperative changes in the sphenoid sinus; this may cause misdiagnosis as showed the case in Figure 10. In this patient there was no border line between the tumor infiltrating the right cavernous sinus and fluid collection inside the right sphenoid sinus on post-contrast T1-weighted images. Conversely, the border line was excellently visible on T2-weighted images.


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)

The fluid collection on the right side of the sphenoid sinus – excellently visible on T2 (arrow). (A) Post-contrast T1-weighted image, coronal plane. (B) Pre-contrast T2-weighted image, coronal plane.
© Copyright Policy
Related In: Results  -  Collection

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

f10-medscimonit-17-10-mt83: The fluid collection on the right side of the sphenoid sinus – excellently visible on T2 (arrow). (A) Post-contrast T1-weighted image, coronal plane. (B) Pre-contrast T2-weighted image, coronal plane.
Mentions: Sometimes the residual tumor may present on post-contrast T1-weighted images with the same signal intensity as postoperative changes in the sphenoid sinus; this may cause misdiagnosis as showed the case in Figure 10. In this patient there was no border line between the tumor infiltrating the right cavernous sinus and fluid collection inside the right sphenoid sinus on post-contrast T1-weighted images. Conversely, the border line was excellently visible on T2-weighted images.

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