Share：
Share this content in WeChat
X
[Chinese][PDF]1257116
• Clinical Article •
Differential diagnosis of pituitary macroadenomas and sellar meningiomas by MRI basic signs combined with ADC value
HAN Tao  ZHANG Jing  WANG Dan  ZHANG Bin  DENG Liangna  LIN Xiaoqiang  JING Mengyuan  ZHOU Junlin 

Cite this article as: Han T, Zhang J, Wang D, et al. Differential diagnosis of pituitary macroadenomas and sellar meningiomas by MRI basic signs combined with ADC value[J]. Chin J Magn Reson Imaging, 2021, 12(5): 6-11. DOI:10.12015/issn.1674-8034.2021.05.002.


[Abstract] Objective To explore the value of MRI signs combined with ADC value in the differential diagnosis of pituitary macroadenomas and sellar meningiomas. Materials andMethods Forty-two cases of pituitary macroadenomas and 40 cases of sellar meningiomas confirmed by pathology, were analyzed retrospectively. All cases were examined by traditional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) before operation.The apparent diffusion coefficient (ADC) value was measured in the solid part of the tumor and compared with the results of pathological diagnosis. t-test, Chi-square test were used in statistical methods, and the diagnostic efficacy of each parameter in differentiating the two groups of tumors was evaluated by the receiver working characteristic (ROC) curve.Results Between pituitary macroadenomas and sellar meningiomas, significant enhancement (33%/95%, χ2＝33.581), waist sign (93%/7.5%, χ2＝50.831), wrapped around internal carotid artery (95%/57.5%, χ2＝16.390), enlarged sella turcica (93%/52.5%, χ2＝16.998), pituitary unrecognizable (95%/47.5%, χ2＝23.135) and pituitary stalk invisible (90%/62.5%, χ2＝7.761) were statistically significant (P＜0.05). The ADCmax (ADCmean and ADCmin) of pituitary macroadenoma and sellar meningioma was (1.126±0.266)×10-3 mm2/s and (0.855±0.176)×10-3 mm2/s [(1.052±0.271)×10-3 mm2/s and (0.817±0.177)×10-3 mm2/s, (0.971±0.288)×10-3 mm2/s and (0.777±0.182)×10-3 mm2/s, P＜0.001]. Among ADC values, ADCmax demonstrated good performance with an AUC of 0.877 (95% CI, 0.791—0.962) and when the cut-off of ADCmax is 0.970×10-3 mm2/s, the sensitivity and specificity of distinguishing them are 81% and 92.5%.Conclusions The basic signs of MRI combined with ADC value have high clinical value in the diagnosis of pituitary macroadenomas and sellar meningiomas, Which can improve the accuracy of preoperative diagnosis.
[Keywords] pituitary macroadenomas；sellar meningiomas；magnetic resonance imaging；diffusion-weighted imaging；apparent diffusion coefficient

HAN Tao1, 2, 3   ZHANG Jing1, 2, 3   WANG Dan1, 3   ZHANG Bin1, 2, 3   DENG Liangna1, 2, 3   LIN Xiaoqiang1, 2, 3   JING Mengyuan1, 2, 3   ZHOU Junlin1, 3*  

1 Department of Radiology, Lanzhou University Second Hospital, Lanzhou 730030, China

2 Second Clinical School, Lanzhou University, Lanzhou 730030, China

3 Key Laboratory of Medical Imaging of Gansu Province, Lanzhou University, Lanzhou 730030, China

Zhou JL, E-mail: lzuzjl601@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS This work was part of National Natural Science Foundation of China (No. 81772006). Lanzhou University Second Hospital "Cuiying Technology Innovation Plan" Applied Basic Research Project (No. CY2017-MS03).
Received  2020-11-13
Accepted  2021-01-21
DOI: 10.12015/issn.1674-8034.2021.05.002
Cite this article as: Han T, Zhang J, Wang D, et al. Differential diagnosis of pituitary macroadenomas and sellar meningiomas by MRI basic signs combined with ADC value[J]. Chin J Magn Reson Imaging, 2021, 12(5): 6-11. DOI:10.12015/issn.1674-8034.2021.05.002.

1
Imber BS, Lin AL, Zhang Z, et al. Comparison of radiographic approaches to assess treatment response in pituitary adenomas: is RECIST or RANO Good enough?[J]. J Endocr Soc, 2019, 3(9): 1693-1706. DOI: 10.1210/js.2019-00130.
2
Bang M, Suh JH, Park JB, Weon YC. Pure intrasellar meningioma mimicking pituitary macroadenoma: magnetic resonance imaging and review of the literature[J]. World Neurosurg, 2016, 91: 675. e1-675. e6754. DOI: 10.1016/j.wneu.2016.04.063.
3
Dzhindzhikhadze RS, Dreval ON, Lazarev VA, et al. Transpalpebral Approach for Microsurgical Removal of Tuberculum Sellae Meningiomas[J]. Asian J Neurosurg, 2020, 15(1): 98-106. DOI: 10.4103/ajns.AJNS_186_19.
4
Cappabianca P, Cirillo S, Alfieri A, et al. Pituitary macroadenoma and diaphragma sellae meningioma: differential diagnosis on MRI[J]. Neuroradiology, 1999, 41(1): 22-26. DOI: 10.1007/s002340050698.
5
Hassan HA, Bessar MA, Herzallah IR, et al. Diagnostic value of early postoperative MRI and diffusion-weighted imaging following trans-sphenoidal resection of non-functioning pituitary macroadenomas[J]. Clin Radiol, 2018, 73(6): 535-541, DOI: 10.1016/j.crad.2017.12.007.
6
Lieb JM, Ahlhelm FJ. Tumors of the sellar region[J]. Radiologe, 2017, 57(9): 740-747. DOI: 10.1007/s00117-017-0270-7.
7
Famini P, Maya MM, Melmed S. Pituitary magnetic resonance imaging for sellar and parasellar masses: ten-year experience in 2598 patients[J]. J Clin Endocrinol Metab, 2011, 96(6): 1633-1641. DOI: 10.1210/jc.2011-0168.
8
Wu LM, Li YL, Yin YH, et al. Usefulness of dual-energy computed tomography imaging in the differential diagnosis of sellar meningiomas and pituitary adenomas: preliminary report[J]. PLoS One, 2014, 9(3): e90658. DOI: 10.1371/journal.pone.0090658.
9
Gatto F, Perez-Rivas LG, Olarescu NC, et al. Diagnosis and treatment of parasellar lesions[J]. Neuroendocrinology, 2020, 110(9-10): 728-739. DOI: 10.1159/000506905.
10
Li X, Lu Y, Xiong J, et al. Presurgical differentiation between malignant haemangiopericytoma and angiomatous meningioma by a radiomics approach based on texture analysis[J]. J Neuroradiol, 2019, 46(5): 281-287. DOI: 10.1016/j.neurad.2019.05.013.
11
Sohu DM, Sohail S, Shaikh R. Diagnostic accuracy of diffusion weighted MRI in differentiating benign and malignant meningiomas[J]. Pak J Med Sci, 2019, 35(3): 726-730. DOI: 10.12669/pjms.35.3.1011.
12
Siempis T, Tsakiris C, Alexiou GA, et al. Diagnostic performance of diffusion and perfusion MRI in differentiating high from low-grade meningiomas: a systematic review and meta-analysis[J]. Clin Neurol Neurosurg, 2020, 190: 105643. DOI: 10.1016/j.clineuro.2019.105643.
13
Luo XS, Zhu J. MRI diagnosis of Sellar region tumors[J]. Sichuan Med, 2013, 34(5): 744-746.
14
Zhu H, Miao Y, Shen Y, et al. The clinical characteristics and molecular mechanism of pituitary adenoma associated with meningioma[J]. J Transl Med, 2019, 17(1): 354. DOI: 10.1186/s12967-019-2103-0.
15
Ntali G, Wass JA. Epidemiology, clinical presentation and diagnosis of non-functioning pituitary adenomas[J]. Pituitary, 2018, 21(2): 111-118. DOI: 10.1007/s11102-018-0869-3.
16
Quan GM,Yuan T, Liu HJ. Differential diagnosis of tuberculum sellae meningioma and anterior pituitary adenoma by MRI[J]. J Clin Radiol, 2006(9): 803-806.
17
Liu L, Lu Y, Peng W, et al. Imaging features of intracranial psammomatous meningioma[J]. J Neuroradiol, 2017, 44(6): 395-399. DOI: 10.1016/j.neurad.2017.06.003.
18
Rieken S, Habermehl D, Welzel T, et al. Long term toxicity and prognostic factors of radiation therapy for secreting and non-secreting pituitary adenomas[J]. Radiat Oncol, 2013, 8: 18. DOI: 10.1186/1748-717X-8-18.
19
Rutland JW, Loewenstern J, Ranti D, et al. Analysis of 7-tesla diffusion-weighted imaging in the prediction of pituitary macroadenoma consistency[J]. J Neurosurg, 2020: 1-9. DOI: 10.3171/2019.12.JNS192940.
20
Xiaoai K, Qing Z, Lei H, et al. Differentiating microcystic meningioma from atypical meningioma using diffusion-weighted imaging[J]. Neuroradiology, 2020, 62(5): 601-607. DOI: 10.1007/s00234-020-02374-3.
21
Giordano M, Samii A, Samii M, et al. Magnetic resonance imaging-apparent diffusion coefficient assessment of vestibular schwannomas: systematic approach, methodology, and pitfalls[J]. World Neurosurg, 2019, 125: e820-e823. DOI: 10.1016/j.wneu.2019.01.176.
22
Ko CC, Chen TY, Lim SW, et al. Prediction of recurrence in solid nonfunctioning pituitary macroadenomas: additional benefits of diffusion-weighted MR imaging[J]. J Neurosurg, 2019, 132(2): 351-359. DOI: 10.3171/2018.10.JNS181783.
23
Su CQ, Zhang X, Pan T, et al. Texture analysis of high b-value diffusion-weighted imaging for evaluating consistency of pituitary macroadenomas[J]. J Magn Reson Imaging, 2020, 51(5): 1507-1513. DOI: 10.1002/jmri.26941.
24
Mahmoud OM, Tominaga A, Amatya VJ, et al. Role of propeller diffusion weighted imaging and apparent diffusion coefficient in the diagnosis of sellar and parasellar lesions[J]. Eur J Radiol, 2010, 74(3): 420-427. DOI: 10.1016/j.ejrad.2009.03.031.
25
Shankar JJS, Hodgson L, Sinha N. Diffusion weighted imaging may help differentiate intracranial hemangiopericytoma from meningioma[J]. J Neuroradiol, 2019, 46(4): 263-267. DOI: 10.1016/j.neurad.2018.11.002.

PREV Predictive value of susceptibility vessel sign for long-term neurologic outcomes in elder patients with malignant middle cerebral artery infarct
NEXT Correlation analysis of 3.0 T magnetic resonance spectroscopy combined with diffusion tensor imaging in children with medulloblastoma
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn