Added Value of Contrast-enhanced 3D-FLAIR MR Imaging for Differentiating Cystic Pituitary Adenoma from Rathke's Cleft Cyst.

Content Provider	Europe PMC
Author	Azuma, Minako Khant, Zaw Aung Kadota, Yoshihito Takeishi, Go Watanabe, Takashi Yokogami, Kiyotaka Takeshima, Hideo Hirai, Toshinori
Copyright Year	2021
Abstract	PurposeHalf of the surgically proven Rathke’s cleft cysts (RCCs) can be preoperatively misdiagnosed as cystic pituitary adenoma (CPA). We aimed to evaluate the usefulness of contrast-enhanced (CE) 3D T2 fluid-attenuated inversion-recovery (3D T2-FLAIR) imaging for differentiating between CPA and RCC.MethodsThis retrospective study included six patients with RCC (all pathologically confirmed) and six patients with CPA (five pathologically confirmed, one clinically diagnosed). The 12 patients underwent pre- and post-contrast T1-weighted (T1W)- and 3D T2-FLAIR imaging at 3T. Based on the degree of enhancement of the lesion wall, two radiologists independently scored the images using a 3-point grading system. Interobserver agreement was calculated by using the κ coefficient. The statistical significance of grading differences was analyzed with the Mann–Whitney U-test. Another neuroradiologist first interpreted conventional MR images (1st session), and then the reader read images to which the 3D T2-FLAIR images had been added (2nd session). Sensitivity, specificity, and accuracy of the reader’s interpretation were calculated.ResultsInterobserver agreement for post-contrast T1W- and 3D T2-FLAIR images was excellent (κ = 1.000 and 0.885, respectively). Although the mean enhancement grade on post-contrast T1W images of RCCs and CPAs was not significantly different, on post-contrast 3D T2-FLAIR images it was significantly higher for RCCs and CPAs (P < 0.05). Three CPAs (50%) showed remarkable, donut-like enhancement along the inner margin of the cyst on CE-3D T2-FLAIR images; this was not the case on CE-T1W images. The sensitivity, specificity, and accuracy of the 2nd session were 1.00, 0.83, and 0.92, respectively, which were improved compared to the 1st session (1.00, 0.50, and 0.75, respectively).ConclusionCE-3D FLAIR imaging is useful for discriminating CPAs and RCCs.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8922349&blobtype=pdf
ISSN	13473182
Journal	Magnetic Resonance in Medical Sciences [Magn Reson Med Sci]
Volume Number	20
DOI	10.2463/mrms.mp.2020-0127
PubMed Central reference number	PMC8922349
Issue Number	4
PubMed reference number	33487606
e-ISSN	18802206
Language	English
Publisher	Japanese Society for Magnetic Resonance in Medicine
Publisher Date	2021-01-25
Access Restriction	Open
Rights License	This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ ©2021 Japanese Society for Magnetic Resonance in Medicine
Subject Keyword	Rathke’ cleft cyst cystic pituitary adenoma 3D T2 fluid-attenuated inversion-recovery imaging
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging