| Autor: |
Hassan RMA; Department of Diagnostic Radiology, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt., Almalki YE; Division of Radiology, Department of Internal Medicine, Medical College, Najran University, Najran 61441, Saudi Arabia., Basha MAA; Department of Diagnostic Radiology, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt., Alduraibi SK; Department of Radiology, College of Medicine, Qassim University, Buraidah 52571, Saudi Arabia., Hassan AH; Internal Medicine Department, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia., Aboualkheir M; Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia., Almushayti ZA; Department of Radiology, College of Medicine, Qassim University, Buraidah 52571, Saudi Arabia., Alduraibi AK; Department of Radiology, College of Medicine, Qassim University, Buraidah 52571, Saudi Arabia., Amer MM; Department of Neurology, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt., Basha AMA; Faculty of General Medicine, Saint Petersburg State University, Egypt Branch, Cairo 11646, Egypt., Refaat MM; Department of Diagnostic Radiology, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt. |
| Abstrakt: |
Understanding the consistency of pituitary macroadenomas is crucial for neurosurgeons planning surgery. This retrospective study aimed to evaluate the utility of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) as non-invasive imaging modalities for predicting the consistency of pituitary macroadenomas. This could contribute to appropriate surgical planning and therefore reduce the likelihood of incomplete resections. The study included 45 patients with pathologically confirmed pituitary macroadenomas. Conventional MRI sequences, DWIs, ADC maps, and pre- and post-contrast MRIs were performed. Two neuroradiologists assessed all of the images. Neurosurgeons assessed the consistency of the tumor macroscopically, and histopathologists examined it microscopically. The MRI findings were compared with postoperative data. According to the operative data, macroadenomas were divided into the two following categories based on their consistency: aspirable (n = 27) and non-aspirable tumors (n = 18). A statistically significant difference in DWI findings was found when comparing macroadenomas of different consistencies ( p < 0.001). Most aspirable macroadenomas (66.7%) were hyperintense according to DWI and hypointense on ADC maps, whereas most non-aspirable macroadenomas (83.3%) were hypointense for DWI and hyperintense on ADC maps. At a cut-off value of 0.63 × 10 -3 mm 2 /s, the ADC showed a sensitivity of 85.7% and a specificity of 75% for the detection of non-aspirable macroadenomas (AUC, 0.946). The study concluded that DWI should be routinely performed in conjunction with ADC measurements in the preoperative evaluation of pituitary macroadenomas. This approach may aid in surgical planning, ensure that appropriate techniques are utilized, and reduce the risk of incomplete resection. |
