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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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Post-contrast T1-weighted image, coronal plane: in the sphenoid sinus there is a round structure with peripheral enhancement – implanted muscle with fascia.
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f11-medscimonit-17-10-mt83: Post-contrast T1-weighted image, coronal plane: in the sphenoid sinus there is a round structure with peripheral enhancement – implanted muscle with fascia.

Mentions: Furthermore, T2-weighted imaging may play an important role in assessment of implanted muscle with fascia. In our material in 3 individuals, an implanted muscle with fascia was identified. It was represented by a round, isointense structure, filling nearly the whole sphenoidal sinus in T1-weighted MRI images. After intravenous contrast administration, the structure was enhanced slightly in its peripheral part, with a central round area of lower signal intensity. Such an image of the implanted muscle was found in 2 patients after 4 months following the operation and in 1 patient 5 months after surgery (Figure 11). The follow-up MRIs (beginning approximately from the 12th postoperative month) revealed a gradual change in the appearance of that material. After contrast administration, the previously distinct border between the enhanced peripheral part and the central hypointense part of the implanted muscle became ill-defined. In further MRI examinations, performed approximately 25 months after surgery or later, the structure inside the sphenoidal sinus remained hypointense after contrast administration. Without the analysis of previous images and the knowledge of the patient’s history, the correct diagnosis of that mass on T1-weighted images would have been impossible (especially its differentiation from fluid cistern).


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)

Post-contrast T1-weighted image, coronal plane: in the sphenoid sinus there is a round structure with peripheral enhancement – implanted muscle with fascia.
© Copyright Policy
Related In: Results  -  Collection

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

f11-medscimonit-17-10-mt83: Post-contrast T1-weighted image, coronal plane: in the sphenoid sinus there is a round structure with peripheral enhancement – implanted muscle with fascia.
Mentions: Furthermore, T2-weighted imaging may play an important role in assessment of implanted muscle with fascia. In our material in 3 individuals, an implanted muscle with fascia was identified. It was represented by a round, isointense structure, filling nearly the whole sphenoidal sinus in T1-weighted MRI images. After intravenous contrast administration, the structure was enhanced slightly in its peripheral part, with a central round area of lower signal intensity. Such an image of the implanted muscle was found in 2 patients after 4 months following the operation and in 1 patient 5 months after surgery (Figure 11). The follow-up MRIs (beginning approximately from the 12th postoperative month) revealed a gradual change in the appearance of that material. After contrast administration, the previously distinct border between the enhanced peripheral part and the central hypointense part of the implanted muscle became ill-defined. In further MRI examinations, performed approximately 25 months after surgery or later, the structure inside the sphenoidal sinus remained hypointense after contrast administration. Without the analysis of previous images and the knowledge of the patient’s history, the correct diagnosis of that mass on T1-weighted images would have been impossible (especially its differentiation from fluid cistern).

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