| Objective: Semi-quantitative and quantitative analysis of DCE-MRI in the diagnosis of normal pituitary,pituitary hyperplasia,microadenoma and macroadenoma of the parameters(TTP?Slopemax,Ktrans,Kep,Ve),to explore the DCE-MRI on pituitary adenoma Diagnosis and differential diagnosis of the value.Methods: 79 cases of pituitary disease(19 cases of pituitary hyperplasia,34 cases of microadenoma,26 cases of macroadenoma)and normal pituitary(clinical symptoms,endocrine and imaging were completely normal of the control group)in our hospital from June 2015 to February 2017 were collected by Endocrine examination,clinical follow-up,diagnostic treatment,postoperative pathology and other means of diagnosis.The time-signal intensity(T-SI)curve was obtained by routine and dynamic enhancement scanning,consequently were divided into three types and qualitatively analyzed.The semi-quantitative parameter peak time(TTP),maximum ascending slope(Slopemax)and quantitative parameter volume transfer constant(Ktrans),rate constant(Kep),extracellular extracellular space volume ratio(Ve)were measured,including normal pituitary,pituitary hyperplasia,microadenoma and macroadenoma.The type of T-SI curve of normal pituitary,pituitary hyperplasia,microadenoma and macroadenoma was analyzed by chi-square test,to analyze the differences between the two and none of the statistical significance.Comparison of the parameters of normal pituitary,pituitary hyperplasia,microadenoma and macroadenoma first single factor analysis of variance,and then compared the two LSD method,and finally the statistical value of the parameters of the ROC curve,obtained curve area,analysis of pituitary adenoma diagnosis and differential diagnosis of the best diagnostic threshold,and calculate the sensitivity,specificity,accuracy.Results: 1.The number of normal pituitary T-SI three types of curves were 13,2,0,pituitary hyperplasia were 15,4,0,microadenomas were 1,24,9,macroadenoma were 14,10,2.2.There were no significant differences in TTP,Slopemax,Ktrans,Kep and Ve between the normal pituitary and pituitary hyperplasia(P>0.05).the Slopemax,Ktrans and Kep values in normal pituitary were higher than those in microadenoma,the TTP value was lower than microadenoma,and the difference was statistically significant(P<0.05).ROC curve analysis: TTP,Ktrans under the ROC curve area is larger(respectively 0.866,0.954),72.655 s as TTP diagnostic threshold,the sensitivity,specificity and accuracy were74%?87%?61% and 0.793 min-1 for Ktrans diagnostic threshold,the sensitivity,specificity and accuracy were 80%,97%,77%.The Slopemax,Ktrans and Kep values in normal pituitary were higher than those in macroadenoma,and the difference was statistically significant(P <0.05).ROC curve analysis: Ktrans,Kep under the ROC curve area is larger(respectively 0.738,0.877),0.808min-1 as Ktrans diagnostic threshold,the sensitivity,specificity and accuracy were 80%,69% 49% and 1.676 min-1 for Kep diagnostic threshold,the sensitivity,specificity and accuracy were 67%,92%,59%.3.The Ktrans and Slopemax values in microadenomas were lower than those in macroadenoma,and the differences were statistically significant(P<0.05).ROC curve analysis: the area under the ROC curve of Ktrans and Slopemax was 0.747 and 0.675 respectively,1.679 as Slopemax diagnostic threshold,the sensitivity,specificity and accuracy were 77%,53%,30% and 0.654min-1 for Ktrans diagnostic threshold,the sensitivity,specificity and accuracy were 50%,97%,47%.4.The Slopemax,Ktrans,Kep values in Pituitary hyperplasia were higher than microadenoma,TTP value was less than microadenoma,and the difference was statistically significant(P<0.05).ROC curve analysis: Slopemax,Ktrans under the ROC curve area was larger(respectively 0.874,0.878),2.969 as Slopemax diagnostic threshold,the sensitivity,specificity and accuracy were 87%,82%,69% and 0.720 min-1 for Ktrans diagnostic threshold,the sensitivity,specificity and specificity were 79%,94%,73% 5.The Slopemax,Ktrans and Kep values were higher than those of macroadenoma,and the difference was statistically significant(P <0.05).ROC curve analysis: Slopemax,Kep under the ROC curve area was larger(respectively(0.763,0.767),2.904 as Slopemax diagnostic threshold,the sensitivity,specificity were 90%,65%,55% and 1.176min-1 for Kep diagnostic threshold,the sensitivity,specificity and accuracy were 61%,96%,57%.Conclusion:1.Normal pituitary and microadenoma,pituitary hyperplasia and microadenoma,microadenoma and macroadenoma T-SI curve types are different,to a certain extent,can identify microadenomas.2.Slopemax,Ktrans parameters can be semi-quantitative,quantitative differential diagnosis of microadenoma and macroadenoma,and reflects the difference between the two blood flow,from the blood supply to explain the different size of the biological characteristics of the two.3.TTP,Slopemax,Ktrans,Kep parameters can be semi-quantitative,quantitative differential diagnosis of pituitary hyperplasia and pituitary adenoma,which Ktrans identification of microadenoma is better,Kep identification of large adenoma is better,and can further reflect the difference between the two pathophysiology;There was no statistically significant difference between the two groups... |
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