Kelly Trinh, Michael Tang, Claire White-Dzuro, Min Lang, Karen Buch, Sandra Rincon
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Tumor volume and solid/cystic component measurements were evaluated by using paired <i>t</i>-tests. Diagnostic confidence levels for non-contrast- and contrast-enhanced evaluations were measured by using a 3-point scale (2 = confident, 1 = adequate, 0 = unsure). Analyses of tumor involvement of cranial nerves (CNs) and adjacent vasculature and diagnostic confidence were performed by using Fisher exact and chi-square tests.</p><p><strong>Results: </strong>No significant difference was observed between residual tumor volumes in both studies (18.86 ± 21.67 cm<sup>3</sup> versus 17.64 ± 23.85 cm<sup>3</sup>, <i>P</i> = .55) and measurements of dominant solid component volume, number of cystic components, and largest cystic component volume (2.71 ± 3.47 cm<sup>3</sup> versus 3.95 ± 5.51 cm<sup>3</sup>, <i>P</i> = .10; 2.5 ± 1.5 versus 2.9 ± 1.5, <i>P</i> = .10; 7.61 ± 13.41 versus 6.84 ± 13.37 cm<sup>3</sup>, <i>P</i> = .22, respectively). Tumor involvement of CNs II (<i>P</i> = .64), III (<i>P</i> = .42), and adjacent vasculature (<i>P</i> = .05) showed no significant differences in detection. Diagnostic confidence was comparable in evaluating CN II, vascular structures, and third ventricle (<i>P</i> > .05) involvement. Higher levels of confidence were observed with bSSFP sequences for the detection of CN III involvement (<i>P</i> = .0001) and with contrast-enhanced T1-weighted imaging for cavernous sinus involvement (<i>P</i> = .02).</p><p><strong>Conclusions: </strong>NCMRI techniques by using a bSSFP sequence provide similar characterization of craniopharyngiomas as contrast-enhanced techniques.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. 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This study evaluates the efficacy of non contrast-enhanced MRI (NCMRI) with a balanced steady-state free precession (bSSFP) sequence compared with CEMRI T1-weighted imaging for craniopharyngioma surveillance.</p><p><strong>Materials and methods: </strong>Twenty-nine patients with craniopharyngioma (16 females/13 males, mean age =21.5 ± 4.3 years) with CEMRIs, including a bSSFP sequence, were evaluated. For each patient, 2 blinded neuroradiologists compared the dimensions of residual craniopharyngioma on non-contrast- and contrast-enhanced sequences. Tumor volume and solid/cystic component measurements were evaluated by using paired <i>t</i>-tests. Diagnostic confidence levels for non-contrast- and contrast-enhanced evaluations were measured by using a 3-point scale (2 = confident, 1 = adequate, 0 = unsure). Analyses of tumor involvement of cranial nerves (CNs) and adjacent vasculature and diagnostic confidence were performed by using Fisher exact and chi-square tests.</p><p><strong>Results: </strong>No significant difference was observed between residual tumor volumes in both studies (18.86 ± 21.67 cm<sup>3</sup> versus 17.64 ± 23.85 cm<sup>3</sup>, <i>P</i> = .55) and measurements of dominant solid component volume, number of cystic components, and largest cystic component volume (2.71 ± 3.47 cm<sup>3</sup> versus 3.95 ± 5.51 cm<sup>3</sup>, <i>P</i> = .10; 2.5 ± 1.5 versus 2.9 ± 1.5, <i>P</i> = .10; 7.61 ± 13.41 versus 6.84 ± 13.37 cm<sup>3</sup>, <i>P</i> = .22, respectively). Tumor involvement of CNs II (<i>P</i> = .64), III (<i>P</i> = .42), and adjacent vasculature (<i>P</i> = .05) showed no significant differences in detection. Diagnostic confidence was comparable in evaluating CN II, vascular structures, and third ventricle (<i>P</i> > .05) involvement. 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引用次数: 0
摘要
背景和目的：对比度增强磁共振成像（CEMRI）是颅咽管瘤监测的常用成像模式，但它存在过敏反应和钆沉积等风险。本研究评估了平衡稳态自由前冲（bSSFP）序列非对比增强磁共振成像（NCMRI）与 CEMRI T1 加权成像在颅咽管瘤监测中的疗效比较。材料和方法：对 29 名颅咽管瘤患者（16 名女性/13 名男性，平均年龄=21.5± 4.3 岁）进行了包括 bSSFP 序列在内的 CEMRI 评估。对于每名患者，两名盲神经放射学专家比较了非对比和对比增强序列上残留颅咽管瘤的尺寸。肿瘤体积和实性/囊性成分的测量采用配对 t 检验进行评估。NC和CE评估的诊断置信度采用3点量表进行测量（2=置信，1=充分，0=不确定）。使用费雪精确检验和卡方检验对肿瘤累及颅神经和邻近血管以及诊断可信度进行分析：结果：两项研究的残余肿瘤体积无明显差异（18.86±21.67 cm3 vs 17.64±23.85 cm3，P=0.55）和优势实性成分体积、囊性成分数量和最大囊性成分体积的测量值（分别为 2.71±3.47 cm3 vs 3.95±5.51 cm3，p=0.10；2.5±1.5 vs 2.9±1.5，p=0.10；7.61±13.41 vs 6.84±13.37cm3，p=0.22）。肿瘤累及颅神经II（p=0.64）、颅神经III（p=0.42）和邻近血管（p=0.05）的检出率无显著差异。在评估颅神经II、血管结构和第三脑室受累情况时，诊断可信度相当（p>0.05）。使用 bSSFP 序列检测颅神经 III 受累的可信度更高（p=0.0001），使用 ce-T1W 检测海绵窦受累的可信度更高（p=0.02）：结论：使用 bSSFP 序列的 NCMRI 技术可提供与对比增强技术相似的颅咽管瘤特征：缩写：3D DRIVE，三维驱动平衡；ACA，大脑前动脉；bSSFP，平衡稳态自由前序；ce-T1W，对比增强 T1 加权成像；CN，颅神经；GTR，全切除；STR，次全切除。
Noncontrast MRI Surveillance of Craniopharyngiomas Using a Balanced Steady-state Free Precession (bSSFP) Sequence.
Background and purpose: Contrast-enhanced MRI (CEMRI) is a commonly used imaging technique for craniopharyngioma surveillance; however, it carries risks such as allergic reaction and gadolinium deposition. This study evaluates the efficacy of non contrast-enhanced MRI (NCMRI) with a balanced steady-state free precession (bSSFP) sequence compared with CEMRI T1-weighted imaging for craniopharyngioma surveillance.
Materials and methods: Twenty-nine patients with craniopharyngioma (16 females/13 males, mean age =21.5 ± 4.3 years) with CEMRIs, including a bSSFP sequence, were evaluated. For each patient, 2 blinded neuroradiologists compared the dimensions of residual craniopharyngioma on non-contrast- and contrast-enhanced sequences. Tumor volume and solid/cystic component measurements were evaluated by using paired t-tests. Diagnostic confidence levels for non-contrast- and contrast-enhanced evaluations were measured by using a 3-point scale (2 = confident, 1 = adequate, 0 = unsure). Analyses of tumor involvement of cranial nerves (CNs) and adjacent vasculature and diagnostic confidence were performed by using Fisher exact and chi-square tests.
Results: No significant difference was observed between residual tumor volumes in both studies (18.86 ± 21.67 cm3 versus 17.64 ± 23.85 cm3, P = .55) and measurements of dominant solid component volume, number of cystic components, and largest cystic component volume (2.71 ± 3.47 cm3 versus 3.95 ± 5.51 cm3, P = .10; 2.5 ± 1.5 versus 2.9 ± 1.5, P = .10; 7.61 ± 13.41 versus 6.84 ± 13.37 cm3, P = .22, respectively). Tumor involvement of CNs II (P = .64), III (P = .42), and adjacent vasculature (P = .05) showed no significant differences in detection. Diagnostic confidence was comparable in evaluating CN II, vascular structures, and third ventricle (P > .05) involvement. Higher levels of confidence were observed with bSSFP sequences for the detection of CN III involvement (P = .0001) and with contrast-enhanced T1-weighted imaging for cavernous sinus involvement (P = .02).
Conclusions: NCMRI techniques by using a bSSFP sequence provide similar characterization of craniopharyngiomas as contrast-enhanced techniques.
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