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Differentiation between Cystic Pituitary Adenomas and Rathke Cleft Cysts: A Diagnostic Model Using MRI.

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Differentiation between Cystic Pituitary Adenomas and Rathke Cleft Cysts: A Diagnostic Model Using MRI.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Park, M. Lee, S-K Choi, J. Kim, S-H Kim, S. H. Shin, N-Y Kim, J. Ahn, S. S.
Description	Author Affiliation: Park M ( From the Department of Radiology, Research Institute of Radiological Science (M.P., S.-K.L., J.K., S.S.A.).); Lee SK ( From the Department of Radiology, Research Institute of Radiological Science (M.P., S.-K.L., J.K., S.S.A.).); Choi J ( Biostatistics Collaboration Unit, Medical Research Center (J.C.).); Kim SH ( Departments of Neurosurgery (S.-H.K.).); Kim SH ( Pathology (S.H.K.), Yonsei University College of Medicine, Seoul, South Korea.); Shin NY ( Department of Radiology (N.-Y.S.), Ewha Womans University School of Medicine, Seoul, South Korea.); Kim J ( From the Department of Radiology, Research Institute of Radiological Science (M.P., S.-K.L., J.K., S.S.A.).); Ahn SS ( From the Department of Radiology, Research Institute of Radiological Science (M.P., S.-K.L., J.K., S.S.A.) sungsoo@yuhs.ac.)
Abstract	BACKGROUND AND PURPOSE: Cystic pituitary adenomas may mimic Rathke cleft cysts when there is no solid enhancing component found on MR imaging, and preoperative differentiation may enable a more appropriate selection of treatment strategies. We investigated the diagnostic potential of MR imaging features to differentiate cystic pituitary adenomas from Rathke cleft cysts and to develop a diagnostic model. MATERIALS AND METHODS: This retrospective study included 54 patients with a cystic pituitary adenoma (40 women; mean age, 37.7 years) and 28 with a Rathke cleft cyst (18 women; mean age, 31.5 years) who underwent MR imaging followed by surgery. The following imaging features were assessed: the presence or absence of a fluid-fluid level, a hypointense rim on T2-weighted images, septation, an off-midline location, the presence or absence of an intracystic nodule, size change, and signal change. On the basis of the results of logistic regression analysis, a diagnostic tree model was developed to differentiate between cystic pituitary adenomas and Rathke cleft cysts. External validation was performed for an additional 16 patients with a cystic pituitary adenoma and 8 patients with a Rathke cleft cyst. RESULTS: The presence of a fluid-fluid level, a hypointense rim on T2-weighted images, septation, and an off-midline location were more common with pituitary adenomas, whereas the presence of an intracystic nodule was more common with Rathke cleft cysts. Multiple logistic regression analysis showed that cystic pituitary adenomas and Rathke cleft cysts can be distinguished on the basis of the presence of a fluid-fluid level, septation, an off-midline location, and the presence of an intracystic nodule (P = .006, .032, .001, and .023, respectively). Among 24 patients in the external validation population, 22 were classified correctly on the basis of the diagnostic tree model used in this study. CONCLUSIONS: A systematic approach using this diagnostic tree model can be helpful in distinguishing cystic pituitary adenomas from Rathke cleft cysts.
File Format	HTM / HTML
ISSN	01956108
e-ISSN	1936959X
Journal	American Journal of Neuroradiology
Issue Number	10
Volume Number	36
Language	English
Publisher	American Journal of Neuroradiology
Publisher Date	2015-10-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Neurology Discipline Radiology Adenoma Diagnosis Central Nervous System Cysts Cysts Magnetic Resonance Imaging Pituitary Neoplasms Diagnosis, Differential Pituitary Gland Pathology Retrospective Studies
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Neurology (clinical)

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