Aims and objectives
Sellar/parasellar tumors constitute 10 to 15% of all primary intracranial neoplasms and are the most common causes of pituitary dysfunction and field of view disturbance [1].
Therefore,
early correct diagnosis and therapy of patients with sellar/parasellar tumors are of high importance in clinical practice.
The most common pituitary tumors are adenomas,
which on MR can present various enhancement patterns and other imaging features.
Therefore pituitary adenomas may be mimicked by other tumors located in the sellar region,
such as meningiomas,
craniopharyngiomas,
Rathke cleft cysts,
metastases,...
Methods and materials
Patients
Seventy-five patients (34 women and 41 men; mean age 58.9 yrs),
with sellar/parasellar tumors were prospectively enrolled in the study.
The histopathological examinations obtained after resection of these tumors revealed: 46 macroadenomas,
12 meningiomas (including 2 meningiomas in an intrasellar location and 10 meningiomas in a parasellar location),
10 craniopharyngiomas: 6 adamantinomatous type (4-intrasellar,
2-suprasellar),
4 squamous-papillary type (suprasellar),
as well as 1 intrasellar hemangioblastoma,
3 intrasellar metastases,
2 suprasellar lymphomas and 1 suprasellar glioma.
Among the adenomas there were: 8 prolactin-secreting adenomas,
1...
Results
Perfusion Measurements
The mean and maximum values of rCBV,
rPH and rPSR,
calculated for different types of examined sellar/parasellar tumors are demonstrated in table 1.
Pituitary macroadenomas revealed high values of the rCBV parameter.
The maximum rCBV values for adenomas ranged between 2.42 and 7.55 (mean max.
rCBV= 5.18).
Sellar meningiomas,
similarly to adenomas,
showed high values of rCBV (ranging 2.99 and 12.18,
mean max.
rCBV= 8.22).
Both pituitary adenomas and sellar meningiomas revealed signal-intensity curves with little or no return to the baseline levels...
Conclusion
In our study we found the pituitary adenomas to appear in PWI as hyperperfused tumors (Fig.4) with elevated rCBV values and maximum rCBV ranging between 2.42 and 7.55 (mean max.
rCBV= 5.18) (table 1).
In gliomas,
the CBV parameter has been reported to correlate positively with the vascular endothelial growth factor (VEGF) [4],
which is also expressed in the normal pituitary gland and pituitary adenomas.
Moreover,
increased concentrations of VEGF and of VEGF receptor 1 (VEGF-R1) were found in non-functioning pituitary adenomas when compared to...
References
1.
Bladowska J,
Zimny A,
Guzinski M et al.
Usefulness of perfusion weighted magnetic resonance imaging with signal-intensity curves analysis in the differential diagnosis of sellar and parasellar tumors: preliminary report.
Eur J Radiol 2013; 82: 1292-98.
2.
Mahmoud OM,
Tominaga A,
Amatya VJ et al.
Role of PROPELLER diffusion weighted imaging and apparent diffusion coefficient in the diagnosis of sellar and parasellar lesions.
Eur J Radiol 2010;74(3):420-7.
3.
Chernov MF,
Kawamata T,
Amano K et al.
Possible role of single-voxel 1H-MRS in differential diagnosis...