The MRI Research Of Intercavernous Sinus

Part Ⅰ: Imaging Features of the Anterior Intercavernous Sinus with MRI T1 WI TSE Sequence Objective To observe the imaging characteristics of the anterior intercavernous sinus,MRI of the anterior intercavernous sinus was retrospectively compared between non-pituitary lesions and pituitary lesions.Methods 78 patients who took pituitary enhanced MRI examination were collected from October 2017 to January 2018 in our hospital consecutively.Inclusion criteria:(1)those whose pituitary was non-pituitary lesions;(2)those whose pituitary with the pituitary adenoma or Rathke cysts;(3)the pituitary MRI examination was performed in 3.0T magnetic resonance scanner in our hospital;(4)There was a clear and obvious border between normal pituitary and lesions tissue.In the PACS workstation,the complete anterior intercavernous sinus and the incomplete anterior intercavernous sinus were observed on MRI T1 WI image.In the sagittal plane of aqueduct of midbrain,an extension line of the sphenoidal planum was line A,line B was a parallel line with line A passing through the the highest signal of anterior intercavernous sinus,and line C was a parallel line with line A at the saddle floor.Value a was the vertical distance between line A and line B,and Value b was the vertical distance between line B and line C.The positional relationship of anterior intercavernous sinus and the sphenoidal planum,anterior intercavernous sinus and saddle floor was analyzed.Results(1)there were 40 cases complete anterior intercavernous sinus,12 cases incomplete anterior intercavernous sinus,and 26 cases without anterior intercavernous sinus respectively.(2)There was no significant difference in value a,value b,a+b,pituitary height between the non-pituitary lesions group and the pituitary lesions group in the complete anterior intercavernous sinus,however there was statistical differences in a/(a+b)between them.(3)the a/(a+b)value of 40 complete anterior intercavernous sinuses was 0.50±0.15,a/(a+b)value of the anterior intercavernous sinus in the non-pituitary lesions group was 0.54±0.12,and a/(a+b)value of anterior intercavernous sinus in the pituitary lesions group was 0.44±0.17.(4)The maximum diameter of pituitary lesions in the pituitary lesions group was negatively correlated with a and a/(a+b),and the correlation coefficients were-0.676(P<0.05),-0.768(P<0.05).The maximum diameter of pituitary lesions was positively correlated with b and a+b,and the correlation coefficients were 0.831(P<0.05),0.541(P<0.05),respectively.Conclusions(1)In small pituitary lesions and non-pituitary lesions,The high signal was anterior intercavernous sinus foreupward the anterior pituitary,below the vertex of tuberculum sellae.(2)Anterior intercavernous sinus increased in a certain range with the increase of the maximum diameter of pituitary lesions.Part Ⅱ: Exploration of 3D VIBE Model of Intercavernous Sinus in Pituitary Non-lesionssObjective 3D VIBE sequences,MIP reconstruction techniques,and pseudo-color techniques were used to establish the 3D model of intercavernous sinus.Methods 17 cases of 3D VIBE sequences were collected continuously in pituitary non-lesions cases from May 2016 to May 2017 in our hospital.Inclusion criteria:(1)In medical imaging center of our hospital,patients took the 3D VIBE examination,who was non-pituitary lesions: meningioma,hemifacial spasm,trigeminal neuralgia,normal persons.(2)There was a complete imaging diagnosis report.After sellar region was target scanned by 3.0T superconductivity MR scanner,the image was MIP projected by Syngo.Via in the post processing workstation,and the intercavernous sinus 3D model was established by punching through the six large gaps and other small gaps.Results(1)In 17 cases of pituitary non-lesion with 3D VIBE examination,high signal of intercavernous sinus was found in anterior,inferior,posterior of pituitary,back of dorsum sella and clivus,they were anterior intercavernous sinus,inferior intercavernous sinus,posterior intercavernous sinus,dorsum sella sinus and basilar sinus respectively,and they communicated with the cavernous sinuses.(2)All of 17 non-lesions pituitary cases who underwent 3D VIBE examination own intercavernous sinus,and the model of intercavernous sinus could be established with moderate difficulty and good repeatability.(3)Every model showed sellar anatomy clearly,which include intercavernous sinus,cavernous sinus,pituitary,and internal carotid artery.(4)The intercavernous sinus total score averaged 4.65±1.91 points.The display rates of anterior intercavernous sinus,inferior intercavernous sinus,posterior intercavernous sinus,dorsum sella sinus and basilar sinus were 82.35%,11.76%,47.06%,82.35%,76.47%.Conclusions(1)The 3D model of the intercavernous sinus could be reconstructed by the MIP of 3D VIBE sequence target images.The structure was clear with good repeatability.(2)The posterosuperior view is the most best perspective of the 3D model of intercavernous sinus.Combined with the above view,the stereoscopic visualization of the five sinus in the intercavernous sinus could be basically met.The part Ⅲ: Comparison of 3D VIBE and CE-MRV in Intercavernous SinusObjective 3D model of the intercavernous sinus was established by MIP reconstruction of 3D VIBE image and CE-MRV image in the pituitary occupying and non-occupying cases,which compare and analysis the display effects of the intercavernous sinus.Methods 21 patients were consecutively collected who took 3D VIBE and CE-MRV examinations from March 2017 to March 2018 in our hospital.Inclusion criteria:(1)In medical imaging center of our hospital,patients examined 3D VIBE and CE-MRV by 3.0T MRI scanner,whose diagnosis were pituitary adenoma,Rathke cyst,meningioma,hemifacial muscle spasm,trigeminal neuralgia;(2)There was a complete imaging diagnosis report.Sellar region was target scanned by 3.0T superconductivity MR scanner,then image was processed to create a 3D intercavernous sinus model by Maximum Intensity Projection of Syngo.Via in the post-processing workstation.Simultaneously,the intercavernous sinus was scored.The contrast noise ratio(CNR)of the intercavernous sinus was calculated after ROI measuring of the intercavernous sinus,gray matter,white matter and air respectively.The difference in the imaging of the intercavernous sinus by 3D VIBE and CE-MRV was analyzed.Results(1)The display rates of 21 intercavernous sinuses on 3min VIBE,3min VIBES,15 min VIBE,15 min VIBES and CE-MRV were 60.00%,58.10%,57.14%,61.94% and 46.57%,respectively.(2)There was no statistically significant difference in the intercavernous sinus score between the pituitary lesions group and the pituitary non-lesions group.(3)15min VIBES and 3min VIBES showed a better sequence for the intercavernous sinus.There was no significant difference between them.CE-MRV and 15 min VIBE showed relatively poor intercavernous sinus.There was no significant difference between them.3min VIBE was in the middle.Conclusions Compared with imagings of 21 cases from 3min VIBE,3min VIBES,15 min VIBE,15 min VIBES and CE-MRV,15 min VIBES and 3min VIBES showed a good sequence for the intercavernous sinus with better contrast ratio.CE-MRV and 15 min VIBE showed relatively poor intercavernous sinus.