Increased diagnostic confidence in the diagnosis of pituitary micro-lesions with the addition of three-dimensional sampling perfection with application-optimized contrasts using different flip-angle evolutions sequences

Abstract

Background Conventional magnetic resonance imaging (MRI) is adversely affected by thick slices, small intersection gaps, and the partial volume effect, leading to the missed diagnosis or misdiagnosis of pituitary micro-lesions. Purpose To evaluate the diagnostic yield of three-dimensional sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-T2 SPACE) sequences compared with a standard MRI protocol for the diagnosis of pituitary micro-lesions. Material and Methods The MRI findings of 664 patients with clinically suspected pituitary lesions were retrospectively analyzed. All patients underwent coronal 3D-T2 SPACE sequences followed by T1-weighted (T1W) imaging. Conventional scanning sequences included coronal and sagittal T1W imaging and post-contrast enhanced coronal and sagittal T1 imaging. All images were independently evaluated by two experienced neuroradiologists. The inter-observer agreement was analyzed using kappa statistics. Results Compared with conventional sequences, there was an increase in diagnostic confidence of 60.3% for the diagnosis of pituitary micro-lesions with the addition of 3D-T2 SPACE sequences. The lesion conspicuity scores of combined conventional and 3D-T2 SPACE sequences were significantly higher than those of conventional imaging (z = -6.403, P < 0.01) and 3D-T2 SPACE sequences (z = -4.243, P < 0.01). In addition, the inter-observer agreement of 3D-T2 SPACE sequences was good (κ = 0.826). Conclusion Combined with routine sequences, post-contrast enhanced 3D-T2 SPACE sequences effectively improve diagnostic confidence in the diagnosis of pituitary micro-lesions. Post-contrast enhanced 3D-T2 SPACE is suitable for detecting pico-adenomas, micro-lesions adjacent to the cavernous sinuses or sellar floor, lesions between the anterior and posterior lobes, and lesions with early phase enhancement.

Evaluation of Changes in the Roots of Cervical and Brachial Plexuses in Avulsion Injuries

“…Регистрируется прогон с чередующимися импульсами возбуждения: +α и -α, где α -угол поворота. Затем регистрируется прогон с неизменным стабильным импульсом α вместо стандартных импульсов на 180° при рутинных последовательностях МРТ [6]. При этом формируются взаимно смещенные артефакты полос.…”

Evaluation of schwannoma using the 3D-SPACE sequence: comparison with the 3D-CISS sequence in 3T-MRI

“…Moreover, threedimensional constructive interference in steady-state (3D-CISS) and three-dimensional sampling perfection with application-optimized contrasts by using different flip angle evolutions (3D-SPACE) sequences provide isotropic information and thinner images in any plane. 3D-SPACE is a T2-weighted 3D turbo spin-echo sequence using a variable flip angle instead of conventional 180° pulse sequences [6,7]. Thin sections result in better spatial resolution and reduced partial volume artifact.…”

MRI Protocol for Pituitary Assessment in Children with Growth or Puberty Disorders—Is Gadolinium Contrast Administration Actually Needed?

“…Of course, due to the higher spatial resolution and higher image quality, 3 T scanners are slowly replacing the 1.5 T ones, but the latter are still used in medical imaging in many centers around the world [ 3 ]. The next step in pituitary imaging strategies was the application of various 3-D imaging techniques (e.g., T2 SPACE, GRASP, TWIST or IT-TWIST) to obtain increased sensitivity of multiplanar imaging, thinner layers, and even higher resolution while reducing artifacts [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Unfortunately, they have been mainly used thus far on adult patients and most of them require gadolinium administration.…”