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Value of Dynamic MRI in Detection of Pituitary Microadenomas<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
李明利 金征宇 陆菁菁 冯逢
LI Meng-Li, JIN Zheng-Yu， LU Jing-Jing, FENG Feng
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. Beijing, China 100730
Abstract
Objective：DMRI (Dynamic MRI) increased the contrast between pituitary adenomatous tissues and normal tissues, so the sensitivity of microadenoma increased, but there is still controversial about the clinical value of DMRI in the diagnosis of pituitary microadenomas. The aim of this study is to evaluate the efficiency of dynamic MRI in detection of pituitary microadenomas compared with nonenhanced MRI and CMRI(conventional enhanced MRI).
Methods：52 patients with pituitary microadenoma and 20 normal people underwent nonenhanced MR-TIWI, D MRI and CMRI with 1.5T scanner（Visart，Toshiba）.Two radiologists evaluated the detection of microadenoma with 5-point scale method based on low signal in the pituitary gland. The Sensitivity, Specificity, Positive predictive value, and Negative predictive value of three MRI procedures were calculated respectively. Areas under ROC curve were also evaluated.
Results：There is high lever of agreement between two readers for three procedures. The DMRI had higher Sensitivity(89.4%) and Negative predictive value (96.2％) than CMRI(Sensitivity 60.6％; Negative predictive value 48.5％)and unenhanced MRI(Sensitivity 31.7%; Nagetive predictive value 38.2%),(p<0.05).The DMRI had largest area under ROC curve (0.910), followed by CMRI( 0.793), and nonenhanced MRI(0.755) . Three procedures had similar Positive predictive value (92.1%,94.1%，89.1%)，but the Specificity of DMRI was worst(62.5％) among three procedures (CMRI:82.5%;nonenhanced MRI: 72.5%).
Conclusion：Dynamic MRI improved Sensitivity and Negative predictive value of the diagnosis of pituitary microadenomas compared with nonenhanced MRI and conventional enhanced MRI. It has high value in clinical study of pituitary microadenoma.
Key words：pituitary microadenoma, MR imaging, Dynamic study, ROC | 
