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Differentiation of postoperative changes and residual tumors in dynamic contrast-enhanced sella MRI after transsphenoidal resection of pituitary adenoma

 Ha Youn Kim  ;  Sung Tae Kim  ;  Hyung-Jin Kim  ;  Pyoung Jeon  ;  Hong Sik Byun  ;  Yi Kyung Kim  ;  Jihoon Cha  ;  Gyeong Min Park  ;  Do-Hyun Nam  ;  Doo-Sik Kong 
 MEDICINE, Vol.98(27) : e16089, 2019 
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Adenoma/diagnostic imaging ; Adenoma/pathology* ; Adenoma/surgery ; Adolescent ; Adult ; Aged ; Diffusion Magnetic Resonance Imaging/methods ; Female ; Humans ; Male ; Middle Aged ; Neoplasm, Residual/diagnostic imaging ; Neoplasm, Residual/pathology* ; Pituitary Neoplasms/diagnostic imaging ; Pituitary Neoplasms/pathology* ; Pituitary Neoplasms/surgery ; Retrospective Studies ; Sella Turcica/diagnostic imaging ; Young Adult
To establish magnetic resonance imaging (MRI) features that differentiate residual tumors from postoperative surgical changes following the transsphenoidal approach of a pituitary adenoma.We analyzed residual enhancements at the tumor bed in 52 patients who underwent dynamic contrast-enhanced sella MRI within 48 hours after surgery and at 6 to 28 months. Patients were divided into 2 groups defined by either peripheral or nodular enhancement patterns. For each group, we measured the maximum thickness of the residual enhancing portion and compared differences in the residual tumor and postoperative changes.Among the tumors examined in the 52 patients, 19 residual tumors showed nodular (n = 16) and peripheral (n = 3) enhancement patterns, and 33 postoperative changes showed nodular (n = 3) and peripheral (n = 30) enhancement patterns. The mean residual tumor thickness was 7.1 mm (range, 2.9-16.8 mm) and 1.9 mm (range, 1.0-7.4 mm) in the postoperative change. Receiver operating characteristic curve analysis revealed that a 3.9-mm thickness was associated with 89% sensitivity, 97% specificity, and 94% accuracy for diagnosis of residual tumor.On immediate postoperative MRI, residual enhancement with greater than 3.9-mm thickness and nodular pattern suggest residual pituitary adenoma tumor.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Cha, Jihoon(차지훈)
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