The MRI Diagnosis And Studies Of Invasive Pituitary Adenoma And Microadenoma

PART ONETHE RESEARCH OF INVASIVE PITUITARY ADENNOMA BY MRI DIAGNOSISObjective:1. Features of invasive pituitary adenomas and imaging analysis.2. To investigate the MRI diagnosis of pituitary adenoma invading the cavernous sinus.Materials and methods:1. Retrospective analysis and comparative research of the clinical and radiographic data of 56 patients with invasive pituitary adenomas surgical treatment and 76 controls of non-invasive pituitary adenomas. (2) With 56 cases of invasive pituitary adenomas and 76 controls of noninvasive pituitary adenomas as the research objects, and the intraoperative determination of pituitary adenomas to cavernous sinus invasion was as the gold standard, analysis and assessment of the medial wall of cavernous sinus and traditional diagnosis of MRI imaging.3. Statistical analysis of the time-signal intensity curve meansured by the dynamic enhanced MRI, with 56 cases of invasive pituitary macroadenomas and 44 cases of noninvasive pituitary macroadenomas as the research objects.Results:1. Invasive pituitary adenomas were more common in patients with macroadenoma than those with microadenomas (χ2= 31.124, P= 31.124< 0.01).2. Detection of invasive pituitary adenomas by the integrity of the medial wall of cavernous sinus on the dynamic enhanced MRI was better than those traditional diagnosis (sensitivity 100%, specificity 95.65%, positive predictive value (PPV) 86.36%, negative predictive value (NPV) 100%and Youden index 0.957).3. The time-signal intensity curve of the dynamic enhanced MRI might be related with invasive pituitary adenomas(χ2= 61.322, P= 61.322< 0.01).Conclusion:1. The application of detection of invasive pituitary adenomas by the integrity of the medial wall of cavernous sinus on the dynamic enhanced MRI provided a reliable preoperative imaging basis.2. The time-signal intensity curve of the dynamic enhanced MRI might be related with invasive pituitary adenomas.PART TWOThe Research of Pituitary Microadenoma by MRI DiagnosisObjective:1. To discuss the diagnostic value of pituitary microadenoma meansured by different enhance MRI.2. To investigate the clinical application of the time-signal intensity curve of dynamic enhance MRI in the pituitary microadenomas.Materials and methods:1. Retrospective analysis and comparative research of the radiographic data of 32 patients with pituitary microadenomas surgical treatment and 30 controls without pituitary adenomas in the same period.2.32 cases with micro adenoma patients and 30 healthy volunteers as the research object, through the dynamic enhanced MRI statistical analysis of the time-signal intensity curve to explore the time-signal intensity curve and dynamic enhancement period enhanced in normal pituitary and micro adenoma between changes. With 32 cases of pituitary microadenomas and 30 controls as the research objects, statistical analysis of the time-signal intensity curve meansured by the dynamic enhanced MRI was performed to study the difference between pituitary microadenomas and healthy controls.Results:1. The combination of sagittal and coronal scanning by dynamic enhanced MRI could raise the detection rate of pituitary microadenoma to 96.88%, and the differences of detection rate were statistically significant. (dynamic enhanced scan vs conventional scan:χ2= 29.930, p= 0.000< 0.01, dynamic enhanced scan vs conventional enhanced scan:χ2= 7.585, p= 0.013< 0.05).2. The differences of the time-signal intensity curve between normal pituitary and pituitary microadenoma were statistically significant (χ2= 36.674, P= 36.674< 0.01), especially in the early period of the dynamic enhanced MRI scan (50-90 s).Conclusion:1. The combination of sagittal and coronary scanning by dynamic enhanced MRI could significantly improve the detection rate of pituitary microadenoma.2. Early period of the dynamic enhanced MRI was the optimal time to distinguish normal pituitary and microadenoma.