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06 January 2020 : Clinical Research  

Relationship Between Pituitary Adenoma Consistency and Extent of Resection Based on Tumor/Cerebellar Peduncle T2-Weighted Imaging Intensity (TCTI) Ratio of the Point on Preoperative Magnetic Resonance Imaging (MRI) Corresponding to the Residual Point on Postoperative MRI

Xiao-Yong Chen1ABCDEF, Chen-Yu Ding1AEF, Hong-Hai You1EF, Jin-Yuan Chen2BC, Chang-Zhen Jiang1A, Xiao-Rong Yan1A, Zhang-Ya Lin1AG, De-Zhi Kang1AG*

DOI: 10.12659/MSM.919565

Med Sci Monit 2020; 26:e919565

Abstract

BACKGROUND: Controversies exist in imaging modalities for predicting adenoma consistency. In this study, we proposed a method of predicting consistency by magnetic resonance T2-sequence imaging based on adenoma to cerebellar peduncle signal (TCTI) ratio.

MATERIAL AND METHODS: Between January 2013 and May 2017, 191 consecutive patients with pituitary adenoma diagnosed at our institution were retrospectively studied. The consistency grade for each lesion was assigned. And the TCTI ratio based on preoperative and postoperative T2-weighted imaging was calculated.

RESULTS: The median TCTI ratio was 1.55, 1.28, and 1.25 for soft, fibrous, and hard adenomas, respectively. The differences were significant for all groups (p<0.001). A cutoff value of 1.38 for soft adenomas was found to be 80.2% sensitive and 88.7% specific. The median ratio of the outermost layer of residual tumor was 1.25 (SD±0.408, 95% CI 1.27–1.42). It was less than that ratio of the upper, lower quarter, and middle region of adenoma, respectively, and the inter-group differences were all statistically significant with p≤0.001. The extent of resection for the soft group was significantly greater than that of the hard group (85.3% vs. 70.6%, p=0.011). Analysis of Variance (ANOVA) revealed that the consistency grade was the influencing factor of degree of resection. p=0.003.

CONCLUSIONS: The TCTI ratio showed a good correlation with pituitary adenoma consistency. We also determined the optimal ratio of the residual adenoma.

Keywords: Decision Support Techniques, Magnetic Resonance Imaging, Pituitary Neoplasms, Adenoma, Adult, Aged, Cerebellar Neoplasms, Cerebellum, China, Middle Aged, middle cerebellar peduncle , Postoperative Period, preoperative period, Prognosis, Retrospective Studies, Sensitivity and Specificity, white matter

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DOI: 10.12659/MSM.938080

Med Sci Monit 2022; 28:e938080

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750