Abstract
ObjectiveTo quantitatively assess the imaging characteristics of sellar lesion in dual-energy computed tomography (CT) imaging for differentiation of sellar meningiomas and pituitary adenomas during the arterial phase (AP) and venous phase (VP).Materials and Methods51 patients with sellar/parasellar tumors (33 macroadenomas and 18 meningiomas) were examined with CT spectral imaging during the AP and the VP. Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in Normalized iodine concentrations (NICs), HU curve slope (λHU), and mean CT values of lesions between the AP and VP were calculated. The two-sample t test was performed to compare quantitative parameters between sellar meningiomas and pituitary adenomas.ResultsNICs, λHU, and mean CT values in patients with sellar meningiomas differed significantly from those in patients with pituitary adenomas: Mean NICs were 43.52 mg/mL±1.35 versus 9.23 mg/mL ±2.44, respectively, during the AP and 52.13 mg/mL ±1.04 versus 24.37 mg/mL ±2.23 respectively, during the VP. λHU were −3.03±3.42 versus −0.53±0.23, respectively, during the AP and −2.96±0.41 versus −0.47±0.25, respectively, during the VP. Mean CT values were 193.63±2.08 versus 63.98±2.85, respectively, during the AP and 203.98±0.18 versus 77.66±0.91, respectively, during the VP. The combination of NIC and Mean CT value during VP had highest sensitivity (90.9%) and specificity (100%) among all phases.ConclusionQuantitative dual-energy CT imaging has promising potential for diagnostic differentiation of sellar meningiomas and pituitary adenomas.
Highlights
Sellar/parasellar tumors constitute 10–15% of all primary intracranial neoplasms and are the most common causes of pituitary dysfunction and field of view disturbance [1,2]
Early correct diagnosis and therapy of patients with sellar/parasellar tumors are of high importance in clinical practice
From June 2011 to March 2013, 80 patients known or suspected to have Sellar/parasellar tumors underwent multiple-phase Computed tomography (CT) scanning in the spectral imaging mode, which was performed by using a Discovery CT750 HD CT scanner (GE Healthcare).Patients who had reliable proof of sellar meningiomas and pituitary adenomas were included
Summary
Sellar/parasellar tumors constitute 10–15% of all primary intracranial neoplasms and are the most common causes of pituitary dysfunction and field of view disturbance [1,2]. 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 MRI can present various enhancement patterns and other imaging features. MRI is the imaging study of choice for evaluation of sellar lesion or in the context of known or highly suspected pathology, the MR appearance of different sellar/parasellar lesions may be very similar, which often leads to misdiagnosis. The proper choice of surgical approach requires the correct preoperative diagnosis of sellar/parasellar tumors [1,4].
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